Skip to main content
Top
Published in: Pediatric Nephrology 1/2005

01-01-2005 | Original Article

Sleep disturbances in pediatric dialysis patients

Authors: Ira D. Davis, Joshua Baron, Mary Ann O’Riordan, Carol L. Rosen

Published in: Pediatric Nephrology | Issue 1/2005

Login to get access

Abstract

Sleep disorders are common in adult dialysis patients, with a prevalence of 60%–80%. To date, sleep disturbances have not been assessed in the pediatric dialysis population. Therefore, the objective of this study is to describe the prevalence of sleep disturbance symptoms in a pediatric dialysis population. We conducted a telephone- or clinic-based interview of 21 children (aged 6–20 years) and their parents in our academic tertiary pediatric dialysis center with questionnaires that assessed four symptom domains of sleep disorders: (1) sleep-disordered breathing, (2) restless leg syndrome or period limb movements (RLS/PLMs), (3) excessive daytime sleepiness, and (4) inadequate sleep time. The presence of a “sleep disturbance” was defined by positive responses in any of the four symptom domains. Overall, 18 (86%) of the children undergoing dialysis [mean age (SD) 14.2 years (1.1), gender (M/F) 11/10] endorsed sleep disturbance symptoms: sleep-disordered breathing (46%), RLS/PLMs (29%), and excessive daytime sleepiness (60%). We conclude that sleep disturbances are very common in pediatric dialysis patients, but may be underrecognized. Given the adverse neurocognitive and physiological outcomes associated with poor sleep, it is important for practitioners caring for children on dialysis to anticipate and screen for treatable sleep conditions.
Appendix
Available only for authorised users
Literature
1.
go back to reference Vegia J, Goncalves N, D’Santos N, Baptista A, Paiva T (1997) Sleep disturbances in end-stage renal disease patients on hemodialysis. Dial Transplant 26:380–383 Vegia J, Goncalves N, D’Santos N, Baptista A, Paiva T (1997) Sleep disturbances in end-stage renal disease patients on hemodialysis. Dial Transplant 26:380–383
2.
go back to reference Walker S, Fine A, Kryger MH (1995) Sleep complaints are common in a dialysis unit. Am J Kidney Dis 26:751–756PubMed Walker S, Fine A, Kryger MH (1995) Sleep complaints are common in a dialysis unit. Am J Kidney Dis 26:751–756PubMed
3.
go back to reference Holley JL, Nespor S, Rault R (1992) A comparison of reported sleep disorders in patients on chronic hemodialysis and continuous peritoneal dialysis. Am J Kidney Dis 19:156–161PubMed Holley JL, Nespor S, Rault R (1992) A comparison of reported sleep disorders in patients on chronic hemodialysis and continuous peritoneal dialysis. Am J Kidney Dis 19:156–161PubMed
4.
go back to reference Mindell JA, Owens JA (2003) A clinical guide to pediatric sleep: diagnosis and management of sleep problems. Lippincott Williams and Wilkins, Philadelphia, pp 314 Mindell JA, Owens JA (2003) A clinical guide to pediatric sleep: diagnosis and management of sleep problems. Lippincott Williams and Wilkins, Philadelphia, pp 314
5.
go back to reference O’Brien LM, Gozal D (2004) Neurocognitive dysfunction and sleep in children: from human to rodent. Pediatr Clin North Am 51:187–202PubMed O’Brien LM, Gozal D (2004) Neurocognitive dysfunction and sleep in children: from human to rodent. Pediatr Clin North Am 51:187–202PubMed
6.
go back to reference Rosen CL, Palermo TM, Larkin EK, Redline S (2002) Health-related quality of life and sleep-disordered breathing in children. Sleep 25:657–666PubMed Rosen CL, Palermo TM, Larkin EK, Redline S (2002) Health-related quality of life and sleep-disordered breathing in children. Sleep 25:657–666PubMed
7.
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545PubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545PubMed
8.
go back to reference NKF-K/DOQI Clinical Practice Guidelines for Anemia of Chronic Disease: update 2000 (2001) Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 37:S182–S238PubMed NKF-K/DOQI Clinical Practice Guidelines for Anemia of Chronic Disease: update 2000 (2001) Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 37:S182–S238PubMed
9.
go back to reference NKF-K/DOQI Clinical Practice Guidelines Hemodialysis Adequacy: update 2000 (2001) Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 37:S7–S64 NKF-K/DOQI Clinical Practice Guidelines Hemodialysis Adequacy: update 2000 (2001) Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 37:S7–S64
10.
go back to reference NKF-K/DOQI Clinical Practice Guidelines for Peritoneal Dialysis Adequacy: update 2000 (2001) Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 37:S65–S136PubMed NKF-K/DOQI Clinical Practice Guidelines for Peritoneal Dialysis Adequacy: update 2000 (2001) Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 37:S65–S136PubMed
11.
go back to reference Holley JL, Nespor S, Rault R (1991) Characterizing sleep disorders in chronic hemodialysis patients. ASAIO Trans 37:M456–M457PubMed Holley JL, Nespor S, Rault R (1991) Characterizing sleep disorders in chronic hemodialysis patients. ASAIO Trans 37:M456–M457PubMed
12.
go back to reference Rosen CL, Larkin EK, Kirchner HL, Emancipator JL, Bivins SF, Surovec SA, Martin RJ, Redline S (2003) Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity. J Pediatr 142:383–389CrossRefPubMed Rosen CL, Larkin EK, Kirchner HL, Emancipator JL, Bivins SF, Surovec SA, Martin RJ, Redline S (2003) Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity. J Pediatr 142:383–389CrossRefPubMed
13.
go back to reference Kimmel PL, Miller G, Mendelson WB (1989) Sleep apnea syndrome in chronic renal disease. Am J Med 86:308–314CrossRefPubMed Kimmel PL, Miller G, Mendelson WB (1989) Sleep apnea syndrome in chronic renal disease. Am J Med 86:308–314CrossRefPubMed
14.
go back to reference Hallet MD, Burden S, Stewart D, Mahony J, Farrell PC (1996) Sleep apnea in ESRD patients on HD and CAPD. Perit Dial Int 16 [Suppl 1]:S429–S433 Hallet MD, Burden S, Stewart D, Mahony J, Farrell PC (1996) Sleep apnea in ESRD patients on HD and CAPD. Perit Dial Int 16 [Suppl 1]:S429–S433
15.
go back to reference Hallett M, Burden S, Stewart D, Mahony J, Farrell P (1995) Sleep apnea in end-stage renal disease patients on hemodialysis and continuous ambulatory peritoneal dialysis. ASAIO J 41:M435–M441PubMed Hallett M, Burden S, Stewart D, Mahony J, Farrell P (1995) Sleep apnea in end-stage renal disease patients on hemodialysis and continuous ambulatory peritoneal dialysis. ASAIO J 41:M435–M441PubMed
16.
go back to reference Collado-Seidel V, Kohnen R, Samtleben W, Hillebrand GF, Oertel WH, Trenkwalder C (1998) Clinical and biochemical findings in uremic patients with and without restless legs syndrome. Am J Kidney Dis 31:324–328PubMed Collado-Seidel V, Kohnen R, Samtleben W, Hillebrand GF, Oertel WH, Trenkwalder C (1998) Clinical and biochemical findings in uremic patients with and without restless legs syndrome. Am J Kidney Dis 31:324–328PubMed
17.
go back to reference Nielson VK (1971) The peripheral nerve function in chronic renal failure. I. Clinical symptoms and signs. Acta Med Scand 190:105–111PubMed Nielson VK (1971) The peripheral nerve function in chronic renal failure. I. Clinical symptoms and signs. Acta Med Scand 190:105–111PubMed
18.
go back to reference Bastani B, Westervelt FB (1987) Effectiveness of clonidine in alleviating the symptoms of “restless legs”. Am J Kidney Dis 10:326–327 Bastani B, Westervelt FB (1987) Effectiveness of clonidine in alleviating the symptoms of “restless legs”. Am J Kidney Dis 10:326–327
19.
go back to reference Winkelman JW, Chertow GM, Lazarus JM (1996) Restless legs syndrome in end-stage renal disease. Am J Kidney Dis 28:372–378PubMed Winkelman JW, Chertow GM, Lazarus JM (1996) Restless legs syndrome in end-stage renal disease. Am J Kidney Dis 28:372–378PubMed
20.
go back to reference Benz RJ, Pressman MR, Paterson DD (1994) Periodic limb movements of sleep index (PLMSI): a sensitive predictor of mortality in dialysis patients. J Am Soc Nephrol 5:433 Benz RJ, Pressman MR, Paterson DD (1994) Periodic limb movements of sleep index (PLMSI): a sensitive predictor of mortality in dialysis patients. J Am Soc Nephrol 5:433
21.
go back to reference Lavigne GJ, Montplaisir JY (1994) Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep 17:739–743PubMed Lavigne GJ, Montplaisir JY (1994) Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep 17:739–743PubMed
22.
go back to reference Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53:547–554CrossRefPubMed Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53:547–554CrossRefPubMed
23.
go back to reference Wadhwa NK, Mendelson WB (1992) A comparison of sleep-disordered respiration in ESRD patients receiving hemodialysis and peritoneal dialysis. Adv Perit Dial 8:195–198PubMed Wadhwa NK, Mendelson WB (1992) A comparison of sleep-disordered respiration in ESRD patients receiving hemodialysis and peritoneal dialysis. Adv Perit Dial 8:195–198PubMed
24.
go back to reference Chervin RD, Archbold KH, Dillon JE, Pituch KJ, Panahi P, Dahl RE, Guilleminault C (2002) Associations between symptoms of inattention, hyperactivity, restless legs, and periodic leg movements. Sleep 25:213–218PubMed Chervin RD, Archbold KH, Dillon JE, Pituch KJ, Panahi P, Dahl RE, Guilleminault C (2002) Associations between symptoms of inattention, hyperactivity, restless legs, and periodic leg movements. Sleep 25:213–218PubMed
25.
go back to reference Picchietti DL, England SJ, Walters AS, Willis K, Verrico T (1998) Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. J Child Neurol 13:588–594PubMed Picchietti DL, England SJ, Walters AS, Willis K, Verrico T (1998) Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. J Child Neurol 13:588–594PubMed
26.
go back to reference Frankenfield DL, Neu AM, Warady BA, Fivush BA, Johnson CA, Brem AS (2003) Anemia in pediatric hemodialysis patients: results from the 2001 ESRD Clinical Performance Measures Project. Kidney Int 64:1120–1124CrossRefPubMed Frankenfield DL, Neu AM, Warady BA, Fivush BA, Johnson CA, Brem AS (2003) Anemia in pediatric hemodialysis patients: results from the 2001 ESRD Clinical Performance Measures Project. Kidney Int 64:1120–1124CrossRefPubMed
27.
go back to reference O’Keefe ST (1993) Restless legs syndrome in the elderly. Postgrad Med J 69:701–703PubMed O’Keefe ST (1993) Restless legs syndrome in the elderly. Postgrad Med J 69:701–703PubMed
28.
29.
go back to reference Salih AM, Gray RE, Mills KR, Webley M (1994) A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis. Br J Rheumatol 33:60–63PubMed Salih AM, Gray RE, Mills KR, Webley M (1994) A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis. Br J Rheumatol 33:60–63PubMed
30.
go back to reference Ben-Sachar (1985) Effects of iron chelators on dopamine DA2 receptors. J Neurochem 145:999–1005 Ben-Sachar (1985) Effects of iron chelators on dopamine DA2 receptors. J Neurochem 145:999–1005
31.
go back to reference Roger SD, Harris DC, Stewart JH (1991) Possible relation between restless legs and anaemia in renal dialysis patients. Lancet 337:1551CrossRef Roger SD, Harris DC, Stewart JH (1991) Possible relation between restless legs and anaemia in renal dialysis patients. Lancet 337:1551CrossRef
32.
go back to reference Jeans WD, Fernando DC, Maw AR, Leighton BC (1981) A longitudinal study of the growth of the nasopharynx and its contents in normal children. Br J Radiol 54:117–121PubMed Jeans WD, Fernando DC, Maw AR, Leighton BC (1981) A longitudinal study of the growth of the nasopharynx and its contents in normal children. Br J Radiol 54:117–121PubMed
35.
go back to reference Hart LG, Evans RW (1987) The functional status of ESRD patients as measured by the Sickness Impact Profile. J Chronic Dis 40 [Suppl 1]:117S–136S Hart LG, Evans RW (1987) The functional status of ESRD patients as measured by the Sickness Impact Profile. J Chronic Dis 40 [Suppl 1]:117S–136S
36.
go back to reference Devins GM, Edworthy SM, Paul LC, Mandin H, Seland TP, Klein G, Costello CG, Shapiro CM (1993) Restless sleep, illness intrusiveness, and depressive symptoms in three chronic illness conditions: rheumatoid arthritis, end-stage renal disease, and multiple sclerosis. J Psychosom Res 37:163–170CrossRefPubMed Devins GM, Edworthy SM, Paul LC, Mandin H, Seland TP, Klein G, Costello CG, Shapiro CM (1993) Restless sleep, illness intrusiveness, and depressive symptoms in three chronic illness conditions: rheumatoid arthritis, end-stage renal disease, and multiple sclerosis. J Psychosom Res 37:163–170CrossRefPubMed
37.
go back to reference Fallone G, Owens JA, Deane J (2002) Sleepiness in children and adolescents: clinical implications. Sleep Med Rev 6:287–306CrossRefPubMed Fallone G, Owens JA, Deane J (2002) Sleepiness in children and adolescents: clinical implications. Sleep Med Rev 6:287–306CrossRefPubMed
38.
go back to reference Drake C, Nickel C, Burduvali E, Roth T, Jefferson C, Pietro B (2003) The pediatric daytime sleepiness scale (PDSS): sleep habits and school outcomes in middle-school children. Sleep 26:455–458PubMed Drake C, Nickel C, Burduvali E, Roth T, Jefferson C, Pietro B (2003) The pediatric daytime sleepiness scale (PDSS): sleep habits and school outcomes in middle-school children. Sleep 26:455–458PubMed
39.
go back to reference Wolfson AR, Carskadon MA (1998) Sleep schedules and daytime functioning in adolescents. Child Dev 69:875–887PubMed Wolfson AR, Carskadon MA (1998) Sleep schedules and daytime functioning in adolescents. Child Dev 69:875–887PubMed
40.
go back to reference Brouhard BH, Donaldson LA, Lawry KW, McGowan KR, Drotar D, Davis I, Rose S, Cohn RA, Tejani A (2000) Cognitive functioning in children on dialysis and post-transplantation. Pediatr Transplant 4:261–267CrossRefPubMed Brouhard BH, Donaldson LA, Lawry KW, McGowan KR, Drotar D, Davis I, Rose S, Cohn RA, Tejani A (2000) Cognitive functioning in children on dialysis and post-transplantation. Pediatr Transplant 4:261–267CrossRefPubMed
41.
go back to reference Lawry KW, Brouhard BH, Cunningham RJ (1994) Cognitive functioning and school performance in children with renal failure. Pediatr Nephrol 8:326–329PubMed Lawry KW, Brouhard BH, Cunningham RJ (1994) Cognitive functioning and school performance in children with renal failure. Pediatr Nephrol 8:326–329PubMed
42.
go back to reference Fennell RS, Fennell EB, Carter RL, Mings EL, Klausner AB, Hurst JR (1990) A longitudinal study of the cognitive function of children with renal failure. Pediatr Nephrol 4:11–15PubMed Fennell RS, Fennell EB, Carter RL, Mings EL, Klausner AB, Hurst JR (1990) A longitudinal study of the cognitive function of children with renal failure. Pediatr Nephrol 4:11–15PubMed
43.
go back to reference Walker SL, Fine A, Kryger MH (1996) l -DOPA/carbidopa for nocturnal movement disorders in uremia. Sleep 19:214–218PubMed Walker SL, Fine A, Kryger MH (1996) l -DOPA/carbidopa for nocturnal movement disorders in uremia. Sleep 19:214–218PubMed
44.
go back to reference Trenkwalder C, Stiasny K, Pollmacher T, Wetter T, Schwarz J, Kohnen R, Kazenwadel J, Kruger HP, Ramm S, Kunzel M, et al. (1995) l -dopa therapy of uremic and idiopathic restless legs syndrome: a double-blind, crossover trial. Sleep 18:681–688PubMed Trenkwalder C, Stiasny K, Pollmacher T, Wetter T, Schwarz J, Kohnen R, Kazenwadel J, Kruger HP, Ramm S, Kunzel M, et al. (1995) l -dopa therapy of uremic and idiopathic restless legs syndrome: a double-blind, crossover trial. Sleep 18:681–688PubMed
45.
go back to reference Walters AS, Mandelbaum DE, Lewin DS, Kugler S, England SJ, Miller M (2000) Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Dopaminergic Therapy Study Group. Pediatr Neurol 22:182–186CrossRefPubMed Walters AS, Mandelbaum DE, Lewin DS, Kugler S, England SJ, Miller M (2000) Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Dopaminergic Therapy Study Group. Pediatr Neurol 22:182–186CrossRefPubMed
46.
go back to reference Winkelman JW, Stauntner A, Samtleben W, Trenkwalder C (2002) Long-term course of restless legs syndrome in dialysis patients after kidney transplantation. Mov Disord 17:1072–1076CrossRefPubMed Winkelman JW, Stauntner A, Samtleben W, Trenkwalder C (2002) Long-term course of restless legs syndrome in dialysis patients after kidney transplantation. Mov Disord 17:1072–1076CrossRefPubMed
47.
go back to reference Melendres CS, Lutz JM, Rubin ED, Marcus CL (2004) Daytime sleepiness and hyperactivity in children with suspected sleep-disordered breathing. Pediatrics (in press) Melendres CS, Lutz JM, Rubin ED, Marcus CL (2004) Daytime sleepiness and hyperactivity in children with suspected sleep-disordered breathing. Pediatrics (in press)
48.
go back to reference Chervin RD, Hedger K, Dillon JE, Pituch KJ (2000) Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med 1:21–32CrossRefPubMed Chervin RD, Hedger K, Dillon JE, Pituch KJ (2000) Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med 1:21–32CrossRefPubMed
49.
go back to reference Owens JA, Spirito A, McGuinn M (2000) The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 23:1043–1051PubMed Owens JA, Spirito A, McGuinn M (2000) The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 23:1043–1051PubMed
50.
go back to reference Parker KP, Kutner NG, Bliwise DL, Bailey JL, Rye DB (2003) Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis. Health Qual Life Outcomes 1:68CrossRefPubMed Parker KP, Kutner NG, Bliwise DL, Bailey JL, Rye DB (2003) Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis. Health Qual Life Outcomes 1:68CrossRefPubMed
51.
go back to reference Langevin B, Fouque D, Leger P, Robert D (1993) Sleep apnea syndrome and end-stage renal disease. Cure after renal transplantation. Chest 103:1330–1335PubMed Langevin B, Fouque D, Leger P, Robert D (1993) Sleep apnea syndrome and end-stage renal disease. Cure after renal transplantation. Chest 103:1330–1335PubMed
52.
go back to reference Hanly PJ, Pierratos A (2001) Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N Engl J Med 344:102–107CrossRefPubMed Hanly PJ, Pierratos A (2001) Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N Engl J Med 344:102–107CrossRefPubMed
53.
go back to reference Hanly PJ, Gabor JY, Chan C, Pierratos A (2003) Daytime sleepiness in patients with CRF: impact of nocturnal hemodialysis. Am J Kidney Dis 41:403–410 Hanly PJ, Gabor JY, Chan C, Pierratos A (2003) Daytime sleepiness in patients with CRF: impact of nocturnal hemodialysis. Am J Kidney Dis 41:403–410
54.
go back to reference Pressman MR, Benz RL, Schleifer CR, Peterson DD (1993) Sleep disordered breathing in ESRD: acute beneficial effects of treatment with nasal continuous positive airway pressure. Kidney Int 43:1134–1139PubMed Pressman MR, Benz RL, Schleifer CR, Peterson DD (1993) Sleep disordered breathing in ESRD: acute beneficial effects of treatment with nasal continuous positive airway pressure. Kidney Int 43:1134–1139PubMed
Metadata
Title
Sleep disturbances in pediatric dialysis patients
Authors
Ira D. Davis
Joshua Baron
Mary Ann O’Riordan
Carol L. Rosen
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Pediatric Nephrology / Issue 1/2005
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-004-1700-0

Other articles of this Issue 1/2005

Pediatric Nephrology 1/2005 Go to the issue