Nephrology Dialysis Transplantation, Vol 14, Issue 6 1496-1502, Copyright © 1999 by Oxford University Press
M Pfister, S Jakob, H Marti, F Frey and M Gugger
Background: Patients with end-stage renal diseases
(ESRD) have an increased risk of sleep-disordered breathing. With regard to
this disorder, controversy persists about prevalence, cost-effective
assessment and socio-economical relevance. Methods:
Therefore, we performed, for the first time, overnight ambulatory oximetry
in combination with a sleep questionnaire in 38 unselected patients with
ESRD and 37 healthy controls. An oxygen desaturation index (ODI)
>15, defined as >15 falls in oxygen saturation of ⩾4%
per h, was observed more frequently in ESRD patients than in healthy
controls (47 vs 3%, P <0.001).
Results: In general, the results derived from the
assessment of the Epworth Sleepiness Scale (ESS) as well as those from the
visual analogue scale (VAS) did not reflect the ODI values of the
respective patients population. Interestingly, 88% of ESRD patients with
the questionnaire finding 'excessively loud snoring' had an ODI of
>15 as compared with 13% without this complaint (P<0.05).
Furthermore, 77% of ESRD patients with a systolic blood pressure
>140 mmHg and a body mass index (BMI) >25, had an ODI of
>15. The percentage of ESRD patients with a professional activity
was higher in the absence of sleep-disordered breathing 63
vs 21%, P <0.05).
Conclusion: 'Excessively loud snoring' and a BMI
>25 combined with hypertension are risk factors for sleep-disordered
breathing in ESRD patients. Nocturnal oxygen desaturations are assessed
efficiently by ambulatory oximetry and correlate with relevant biological
and socio-economical parameters in ESRD patients. Key
words: end-stage renal disease; haemodialysis; oximetry;
peritoneal dialysis; sleep apnoea
ORIGINAL ARTICLES
Ambulatory nocturnal oximetry and sleep questionnaire-based findings in 38 patients with end-stage renal disease
Division of Nephrology and Division of Pneumology, Department of Medicine, University of Berne, Inselspital, CH-3010 Bern, Switzerland; Corresponding author
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