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Sleep disorders in pediatric chronic kidney disease patients

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Abstract

The prevalence of sleep disorders during childhood has been estimated to range from 25 to 43 %. The aim of this review is to determine the prevalence of sleep disorders and possible associations with chronic kidney disease (CKD)-related factors and health-related quality of life (HRQOL) in children with CKD. An electronic systematic literature search for sleep disorders in children with CKD in Pubmed, Embase and the Cochrane Library Databases identified seven relevant articles for review, all of which reported an increased prevalence of sleep disorders in children with CKD. Five studies included children with CKD undergoing dialysis, and two studies included only non-dialysis patients. In all studies the presence of sleep disturbances was assessed by questionnaires; only one study compared the results of a validated questionnaire with laboratory-based polysomnography. The prevalence of any sleep disorder ranged from 77 to 85 % in dialysis patients, to 32–50 % in transplanted patients and 40–50 % in non-dialysis patients. The most commonly studied disorder was restless legs syndrome, which presented at a prevalence of 10–35 %. Three studies showed significant associations between presence of sleep disorders and HRQOL. We found consistent evidence of an increased prevalence of sleep disturbances in children with CKD, and these seemed to play a critical role in HRQOL.

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References

  1. Boyle J, Cropley M (2004) Children's sleep: problems and solutions. J Fam Health Care 14:61–63

    PubMed  Google Scholar 

  2. Owens J (2008) Classification and epidemiology of childhood sleep disorders. Prim Care 35:533–546

    Article  PubMed  Google Scholar 

  3. Beebe DW (2011) Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatr Clin North Am 58:649–665

    Article  PubMed  PubMed Central  Google Scholar 

  4. Owens JA (2001) The practice of pediatric sleep medicine: results of a community survey. Pediatrics 108, E51

    Article  CAS  PubMed  Google Scholar 

  5. O'Brien LM, Gozal D (2004) Neurocognitive dysfunction and sleep in children: from human to rodent. Pediatr Clin North Am 51:187–202

    Article  PubMed  Google Scholar 

  6. Garaulet M, Ortega FB, Ruiz JR, Rey-López JP, Béghin L, Manios Y, Cuenca-García M, Plada M, Diethelm K, Kafatos A, Molnár D, Al-Tahan J, Moreno LA (2011) Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study Int J Obes (Lond) 35:1308–1317

    Article  CAS  Google Scholar 

  7. Kong AP, Wing YK, Choi KC, Li AM, Ko GT, Ma RC, Tong PC, Ho CS, Chan MH, Ng MH, Lau J, Chan JC (2011) Associations of sleep duration with obesity and serum lipid profile in children and adolescents. Sleep Med 12:659–665

    Article  PubMed  Google Scholar 

  8. Gerson AC, Butler R, Moxey-Mims M, Wentz A, Shinnar S, Lande MB, Mendley SR, Warady BA, Furth SL, Hooper SR (2006) Neurocognitive outcomes in children with chronic kidney disease: current findings and contemporary endeavors. Ment Retard Dev Disabil Res Rev 12:208–215

    Article  PubMed  Google Scholar 

  9. Fadrowski J, Cole SR, Hwang W, Fiorenza J, Weiss RA, Gerson A, Furth SL (2006) Changes in physical and psychosocial functioning among adolescents with chronic kidney disease. Pediatr Nephrol 21:394–399

    Article  PubMed  Google Scholar 

  10. Deeks JJ1, Dinnes J, D'Amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG; in collaboration with the International Stroke Trial and the EuropeanCarotid Surgery Trial Collaborative Group (2003) Evaluating nonrandomised intervention studies. Health Technol Assess 2003:7(27)

  11. Slickers J, Duquette P, Hooper S, Gipson D (2007) Clinical predictors of neurocognitive deficits in children with chronic kidney disease. Pediatr Nephrol 22:565–572

    Article  PubMed  Google Scholar 

  12. De Santo RM, Bartiromo M, Cesare CM, Cirillo M (2008) Sleep disorders occur very early in chronic kidney disease. J Nephrol 21:S59–S65

    PubMed  Google Scholar 

  13. Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, Kurokawa K, Rayner HC, Furniss AL, Port FK, Saran R (2008) Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the dialysis outcomes and practice patterns study (DOPPS). Nephrol Dial Transplant 23:998–1004

    Article  PubMed  Google Scholar 

  14. Nicholl DD, Ahmed SB, Loewen AH, Hemmelgarn BR, Sola DY, Beecroft JM, Turin TC, Hanly PJ (2012) Declining kidney function increases the prevalence of sleep apnea and nocturnal hypoxia. Chest 141:1422–1430

    Article  PubMed  Google Scholar 

  15. Sabbatini M, Crispo A, Pisani A, Gallo R, Cianciaruso B, Fuiano G, Federico S, Andreucci VE (2005) Sleep quality in renal transplant patients: a never investigated problem. Nephrol Dial Transplant 20:194–198

    Article  PubMed  Google Scholar 

  16. Lewandowski AS, Ward TM, Palermo TM (2011) Sleep problems in children and adolescents with common medical conditions. Pediatr Clin North Am 58:699–713

    Article  PubMed  PubMed Central  Google Scholar 

  17. Davis ID, Baron J, O'riordan MA, Rosen CL (2005) Sleep disturbances in pediatric dialysis patients. Pediatr Nephrol 20:69–75

    Article  PubMed  Google Scholar 

  18. Applebee GA, Guillot AP, Schuman CC, Teddy S, Attarian HP (2009) Restless legs syndrome in pediatric patients with chronic kidney disease. Pediatr Nephrol 24:545–548

    Article  PubMed  Google Scholar 

  19. Sinha R, Davis ID, Matsuda-Abedini M (2009) Sleep disturbances in children and adolescents with non-dialysis-dependent chronic kidney disease. Arch Pediatr Adolesc Med 163:850–855

    Article  PubMed  Google Scholar 

  20. Roumelioti ME, Wentz A, Schneider MF, Gerson AC, Hooper S, Benfield M, Warady BA, Furth SL, Unruh ML (2010) Sleep and fatigue symptoms in children and adolescents with CKD: a cross-sectional analysis from the chronic kidney disease in children (CKiD) study. Am J Kidney Dis 55:269–280

    Article  PubMed  PubMed Central  Google Scholar 

  21. Davis ID, Greenbaum LA, Gipson D, Wu LL, Sinha R, Matsuda-Abedini M, Emancipator JL, Lane JC, Hodgkins K, Nailescu C, Barletta GM, Arora S, Mahan JD, Rosen CL (2012) Prevalence of sleep disturbances in children and adolescents with chronic kidney disease. Pediatr Nephrol 27:451–459

    Article  PubMed  Google Scholar 

  22. Riar SK, Leu RM, Turner-Green TC, Rye DB, Kendrick-Allwood SR, McCracken C, Bliwise DL, Greenbaum LA (2013) Restless legs syndrome in children with chronic kidney disease. Pediatr Nephrol 28:773–795

    Article  PubMed  Google Scholar 

  23. El-Refaey AM, Elsayed RM, Sarhan A, Bakr A, Hammad A, Elmougy A, Aboelyazeed AY (2013) Sleep quality assessment using polysomnography in children on regular hemodialysis. Saudi J Kidney Dis Transpl 24:714–718

    Article  PubMed  Google Scholar 

  24. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J, Restless Legs Syndrome Diagnosis and Epidemiology workshop at the National Institutes of Health; International Restless Legs Syndrome Study Group (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119

    Article  PubMed  Google Scholar 

  25. Plantinga L, Lee K, Inker LA, Saran R, Yee J, Gillespie B, Rolka D, Saydah S, Powe NR, Surveillance Team CDCCKD (2011) Association of sleep-related problems with CKD in the United States, 2005–2008. Am J Kidney Dis 58:554–564

    Article  PubMed  Google Scholar 

  26. Hanly P (2009) Sleep disorders and home dialysis. Adv Chronic Kidney Dis 16:179–188

    Article  PubMed  Google Scholar 

  27. Koch BC, Nagtegaal JE, Hagen EC, Wee PM, Kerkhof GA (2010) Different melatonin rhythms and sleep-wake rhythms in patients on peritoneal dialysis, daytime hemodialysis and nocturnal hemodialysis. Sleep Med 11:242–246

    Article  PubMed  Google Scholar 

  28. Russcher M, Nagtegaal JE, Nurmohamed SA, Koch BC, van der Westerlaken MM, van Someren EJ, Bakker SJ, Ter Wee PM, Gaillard CA (2015) The effects of kidney transplantation on sleep, melatonin, circadian rhythm and quality of life in kidney transplant recipients and living donors. Nephron Physiol 129:6–15

    Article  CAS  Google Scholar 

  29. Silva DS, Andrade Edos S, Elias RM, David-Neto E, Nahas WC, Castro MC, Castro MC (2012) The perception of sleep quality in kidney transplant patients during the first year of transplantation. Clinics (Sao Paulo) 67:1365–1371

    Article  Google Scholar 

  30. Rodrigues CJ, Marson O, Togeiro SM, Tufik S, Ribeiro AB, Tavares A (2010) Sleep-disordered breathing changes after kidney transplantation: a polysomnographic study. Nephrol Dial Transplant 25:2011–2015

    Article  PubMed  Google Scholar 

  31. Lee JJ, Kim GS, Kim JA, Kim SJ, Kang JG, Kim GH, Jung HH (2011) Improvement of sleep-related breathing disorder in patients with end-stage renal disease after kidney transplantation. Clin Transplant 25:126–130

    Article  PubMed  Google Scholar 

  32. Chen G, Ratcliffe J, Olds T, Magarey A, Jones M, Leslie E (2014) BMI, health behaviors, and quality of life in children and adolescents: a school-based study. Pediatrics 133:e868–e874

    Article  PubMed  Google Scholar 

  33. Giannaki CD, Hadjigeorgiou GM, Karatzaferi C, Maridaki MD, Koutedakis Y, Founta P, Tsianas N, Stefanidis I, Sakkas GK (2013) A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome. Nephrol Dial Transplant 28:2834–2840

    Article  PubMed  Google Scholar 

  34. Roumelioti ME, Argyropoulos C, Buysse DJ, Nayar H, Weisbord SD, Unruh ML (2010) Sleep quality, mood, alertness and their variability in CKD and ESRD. Nephron Clin Pract 114:c277–c287

    Article  PubMed  PubMed Central  Google Scholar 

  35. Unruh M, Kurella Tamura M, Larive B, Rastogi A, James S, Schiller B, Gassman J, Chan C, Lockridge R, Kliger A (2011) Impact of sleep quality on cardiovascular outcomes in hemodialysis patients: results from the frequent hemodialysis network study. Am J Nephrol 33:398–406

    Article  PubMed  PubMed Central  Google Scholar 

  36. Magee CA, Gordon R, Caputi P (2014) Distinct developmental trends in sleep duration during early childhood. Pediatrics 133:e1561–e1567

    Article  PubMed  Google Scholar 

  37. Quinn C, Uzbeck M, Saleem I, Cotter P, Ali J, O'Malley G, Gilmartin JJ, O'Keeffe ST (2011) Iron status and chronic kidney disease predict restless legs syndrome in an older hospital population. Sleep Med 12:295–301

    Article  PubMed  Google Scholar 

  38. Novak M, Mendelssohn D, Shapiro CM, Mucsi I (2006) Diagnosis and management of sleep apnea syndrome and restless legs syndrome in dialysis patients. Semin Dial 19:210–216

    Article  PubMed  Google Scholar 

  39. Peirano PD, Algarín CR, Chamorro RA, Reyes SC, Durán SA, Garrido MI, Lozoff B (2010) Sleep alterations and iron deficiency anemia in infancy. Sleep Med 11:637–642

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Pediatric Nephrology Unit, 1st Pediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece

    Stella Stabouli, Eleni Papadimitriou, Nikoleta Printza, John Dotis & Fotios Papachristou

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  1. Stella Stabouli
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  2. Eleni Papadimitriou
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  3. Nikoleta Printza
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Correspondence to Stella Stabouli.

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Stabouli, S., Papadimitriou, E., Printza, N. et al. Sleep disorders in pediatric chronic kidney disease patients. Pediatr Nephrol 31, 1221–1229 (2016). https://doi.org/10.1007/s00467-015-3237-9

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