International Urology and Nephrology

, Volume 41, Issue 2, pp 373–382 | Cite as

Sleep disorders and quality of life in renal transplant recipients

Nephrology - Review
First Online:
Received:
Accepted:

Abstract

Kidney transplantation provides the best outcome for patients with end-stage renal failure both in terms of morbidity and mortality and health-related quality of life (QoL). Health-related QoL has become recognized as an important outcome measure in patients with different chronic medical conditions, including chronic kidney disease (CKD). There are several factors in kidney-transplanted patients which have a negative impact on QoL in these patients. Sleep disorders, such as insomnia, sleep apnea syndrome (SAS), and restless legs syndrome (RLS), are common in kidney-transplanted patients and clearly belong to this group of factors, although there is only limited published data available about the association between sleep problems and QoL in this patient population. The prevalence of both insomnia and RLS is reduced in kidney-transplanted patients compared to dialysis patients, and it is similar to the prevalence observed in the general population. The prevalence of sleep apnea, however, is very high, around 30%. The association between the presence of these sleep disorders and impaired QoL has been relatively well documented in dialysis patients, but there is only scarce published information about this association in the kidney transplant population. In this paper, we will summarize data from the literature describing the impact of sleep problems, which are potentially treatable, on QoL in kidney-transplanted patients. We suggest that the appropriate diagnosis and management of sleep disorders may improve QoL in kidney-transplanted patients.

Keywords

Insomnia Kidney transplantation Quality of life Restless legs syndrome Sleep apnea Sleep disorders Chronic kidney disease 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgments

This study was supported by grants from the National Research Fund (OTKA) (T-048767, TS-049785, F-68841), ETT (100/2006), the Hungarian Kidney Foundation, and the Foundation for Prevention in Medicine. This paper was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences (Marta Novak and Miklos Zsolt Molnar). Miklos Zsolt Molnar was the recipient of the Hungarian Eötvös Scholarship. Marta Novak has been supported by a grant from the Center for Integrative Mood Research, Toronto, Canada.

References

  1. 1.
    Wolfe RA, Ashby VB, Milford EL et al (1999) Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 341:1725–1730. doi: 10.1056/NEJM199912023412303 PubMedCrossRefGoogle Scholar
  2. 2.
    Valderrábano F, Jofré R, López-Gómez JM (2001) Quality of life in end-stage renal disease patients. Am J Kidney Dis 38:443–464. doi: 10.1053/ajkd.2001.26824 PubMedCrossRefGoogle Scholar
  3. 3.
    Cameron JI, Whiteside C, Katz J et al (2000) Differences in quality of life across renal replacement therapies: a meta-analytic comparison. Am J Kidney Dis 35:629–637. doi: 10.1016/S0272-6386(00)70009-6 PubMedCrossRefGoogle Scholar
  4. 4.
    Baines LS, Joseph JT, Jindal RM (2002) Emotional issues after kidney transplantation: a prospective psychotherapeutic study. Clin Transplant 16:455–460. doi: 10.1034/j.1399-0012.2002.02080.x PubMedCrossRefGoogle Scholar
  5. 5.
    Evans RW (1991) Recombinant human erythropoietin and the quality of life of end-stage renal disease patients: a comparative analysis. Am J Kidney Dis 18:62–70PubMedGoogle Scholar
  6. 6.
    Matas AJ, Halbert RJ, Barr ML et al (2002) Life satisfaction and adverse effects in renal transplant recipients: a longitudinal analysis. Clin Transplant 16:113–121. doi: 10.1034/j.1399-0012.2002.1o126.x PubMedCrossRefGoogle Scholar
  7. 7.
    Gudex CM (1995) Health-related quality of life in endstage renal failure. Qual Life Res 4:359–366. doi: 10.1007/BF01593889 PubMedCrossRefGoogle Scholar
  8. 8.
    Pietrabissa A, Ciaramella A, Carmellini M et al (1992) Effect of kidney transplantation on quality of life measures. Transpl Int 5(Suppl 1):S708–S710PubMedGoogle Scholar
  9. 9.
    Jofré R, López-Gómez JM, Moreno F et al (1998) Changes in quality of life after renal transplantation. Am J Kidney Dis 32:93–100. doi: 10.1053/ajkd.1998.v32.pm9669429 PubMedCrossRefGoogle Scholar
  10. 10.
    Rebollo P, Ortega F, Baltar JM et al (2000) Health related quality of life (HRQOL) of kidney transplanted patients: variables that influence it. Clin Transplant 14:199–207. doi: 10.1034/j.1399-0012.2000.140304.x PubMedCrossRefGoogle Scholar
  11. 11.
    Fujisawa M, Ichikawa Y, Yoshiya K et al (2000) Assessment of health-related quality of life in renal transplant and hemodialysis patients using the SF-36 health survey. Urology 56:201–206. doi: 10.1016/S0090-4295(00)00623-3 PubMedCrossRefGoogle Scholar
  12. 12.
    Kutner NG (2008) Promoting functioning and well-being in older CKD patients: review of recent evidence. Int Urol Nephrol 40:1151–1158. doi: 10.1007/s11255-008-9469-x PubMedCrossRefGoogle Scholar
  13. 13.
    Kutner NG, Zhang R, Huang Y et al (2008) Patient-reported sleep difficulty and cognitive function during the first year of dialysis. Int Urol Nephrol 40:203–210. doi: 10.1007/s11255-007-9188-8 PubMedCrossRefGoogle Scholar
  14. 14.
    Ogutmen B, Yildirim A, Sever MS et al (2006) Health-related quality of life after kidney transplantation in comparison intermittent hemodialysis, peritoneal dialysis, and normal controls. Transplant Proc 38:419–421. doi: 10.1016/j.transproceed.2006.01.016 PubMedCrossRefGoogle Scholar
  15. 15.
    Bergner M, Bobbitt RA, Carter WB et al (1981) The Sickness Impact Profile: development and final revision of a health status measure. Med Care 19:787–805. doi: 10.1097/00005650-198108000-00001 PubMedCrossRefGoogle Scholar
  16. 16.
    Devins GM, Dion R, Pelletier LG et al (2001) Structure of lifestyle disruptions in chronic disease: a confirmatory factor analysis of the Illness Intrusiveness Ratings Scale. Med Care 39:1097–1104. doi: 10.1097/00005650-200110000-00007 PubMedCrossRefGoogle Scholar
  17. 17.
    Overbeck I, Bartels M, Decker O et al (2005) Changes in quality of life after renal transplantation. Transplant Proc 37:1618–1621. doi: 10.1016/j.transproceed.2004.09.019 PubMedCrossRefGoogle Scholar
  18. 18.
    Chiu SF, Wong HS, Morad Z et al (2004) Quality of life in cadaver and living-related renal transplant recipients in Kuala Lumpur hospital. Transplant Proc 36:2030–2031. doi: 10.1016/j.transproceed.2004.08.105 PubMedCrossRefGoogle Scholar
  19. 19.
    Kizilisik AT, Feurer ID, Van Buren DH et al (2003) Effects of diabetes and cadaveric organs on functional performance and health-related quality of life after kidney transplantation. Am J Surg 186:535–539. doi: 10.1016/j.amjsurg.2003.07.013 PubMedCrossRefGoogle Scholar
  20. 20.
    Griva K, Ziegelmann JP, Thompson D et al (2002) Quality of life and emotional responses in cadaver and living related renal transplant recipients. Nephrol Dial Transplant 17:2204–2211. doi: 10.1093/ndt/17.12.2204 PubMedCrossRefGoogle Scholar
  21. 21.
    Rebollo P, Ortega F, Baltar JM et al (2001) Is the loss of health-related quality of life during renal replacement therapy lower in elderly patients than in younger patients? Nephrol Dial Transplant 16:1675–1680. doi: 10.1093/ndt/16.8.1675 PubMedCrossRefGoogle Scholar
  22. 22.
    Manu MA, Radulescu S, Harza M et al (2001) Quality of life assessed by SF-36 health survey in renal transplant patients. Transplant Proc 33:1927–1928. doi: 10.1016/S0041-1345(00)02715-9 PubMedCrossRefGoogle Scholar
  23. 23.
    Gross CR, Limwattananon C, Matthees B et al (2000) Impact of transplantation on quality of life in patients with diabetes and renal dysfunction. Transplantation 70:1736–1746. doi: 10.1097/00007890-200012270-00013 PubMedCrossRefGoogle Scholar
  24. 24.
    Basok EK, Atsu N, Rifaioglu MM et al. (2008) Assessment of female sexual function and quality of life in predialysis, peritoneal dialysis, hemodialysis, and renal transplant patients. Int Urol Nephrol. doi: 10.1007/s11255-008-9475-z Google Scholar
  25. 25.
    Cleemput I, Dobbels F (2007) Measuring patient-reported outcomes in solid organ transplant recipients: an overview of instruments developed to date. Pharmacoeconomics 25:269–286. doi: 10.2165/00019053-200725040-00002 PubMedCrossRefGoogle Scholar
  26. 26.
    Hays RD, Kallich JD, Mapes DL et al (1994) Development of the kidney disease quality of life (KDQOL) instrument. Qual Life Res 3:329–338. doi: 10.1007/BF00451725 PubMedCrossRefGoogle Scholar
  27. 27.
    Mapes DL, Bragg-Gresham JL, Bommer J et al (2004) Health-related quality of life in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 44:54–60. doi: 10.1016/S0272-6386(04)01106-0 PubMedCrossRefGoogle Scholar
  28. 28.
    Barotfi S, Molnar MZ, Almasi C et al (2006) Validation of the Kidney Disease Quality of Life-Short Form questionnaire in kidney transplant patients. J Psychosom Res 60:495–504. doi: 10.1016/j.jpsychores.2005.09.009 PubMedCrossRefGoogle Scholar
  29. 29.
    Lofaso F, Verschueren P, Rande JL et al (1994) Prevalence of sleep-disordered breathing in patients on a heart transplant waiting list. Chest 106:1689–1694. doi: 10.1378/chest.106.6.1689 PubMedCrossRefGoogle Scholar
  30. 30.
    Brilakis ES, Olson EJ, McGregor CG et al (2000) Sleep apnea in heart transplant recipients: type, symptoms, risk factors, and response to nasal continuous positive airway pressure. J Heart Lung Transplant 19:330–336. doi: 10.1016/S1053-2498(00)00067-X PubMedCrossRefGoogle Scholar
  31. 31.
    Villa M, Lage E, Quintana E et al (2003) Prevalence of sleep breathing disorders in outpatients on a heart transplant waiting list. Transplant Proc 35:1944–1945. doi: 10.1016/S0041-1345(03)00655-9 PubMedCrossRefGoogle Scholar
  32. 32.
    Skobel E, Kaminski R, Breuer C et al (2000) Remission of nocturnal pathological respiratory patterns after orthotopic heart transplantation. A case report and overview of current status of therapy. Med Klin (Munich) 95:706–711. doi: 10.1007/PL00002090 CrossRefGoogle Scholar
  33. 33.
    Roebuck T, Solin P, Kaye DM et al (2004) Increased long-term mortality in heart failure due to sleep apnoea is not yet proven. Eur Respir J 23:735–740. doi: 10.1183/09031936.04.00060404 PubMedCrossRefGoogle Scholar
  34. 34.
    Javaheri S, Abraham WT, Brown C et al (2004) Prevalence of obstructive sleep apnoea and periodic limb movement in 45 subjects with heart transplantation. Eur Heart J 25:260–266. doi: 10.1016/j.ehj.2003.10.032 PubMedCrossRefGoogle Scholar
  35. 35.
    Kaw R, Golish J, Ghamande S et al (2006) Incremental risk of obstructive sleep apnea on cardiac surgical outcomes. J Cardiovasc Surg (Torino) 47:683–689Google Scholar
  36. 36.
    Kaw R, Michota F, Jaffer A et al (2006) Unrecognized sleep apnea in the surgical patient: implications for the perioperative setting. Chest 129:198–205. doi: 10.1378/chest.129.1.198 PubMedCrossRefGoogle Scholar
  37. 37.
    Littlefield C, Abbey S, Fiducia D et al (1996) Quality of life following transplantation of the heart, liver, and lungs. Gen Hosp Psychiatry 18:36S–47S. doi: 10.1016/S0163-8343(96)00082-5 PubMedCrossRefGoogle Scholar
  38. 38.
    Cohen L, Littlefield C, Kelly P et al (1998) Predictors of quality of life and adjustment after lung transplantation. Chest 113:633–644. doi: 10.1378/chest.113.3.633 PubMedCrossRefGoogle Scholar
  39. 39.
    Neuhaus P, McMaster P, Calne R et al (1994) Neurological complications in the European multicentre study of FK 506 and cyclosporin in primary liver transplantation. Transpl Int 7(Suppl 1):S27–S31. doi: 10.1111/j.1432-2277.1994.tb01305.x PubMedCrossRefGoogle Scholar
  40. 40.
    Kreitzer MJ, Gross CR, Ye X et al (2005) Longitudinal impact of mindfulness meditation on illness burden in solid-organ transplant recipients. Prog Transplant 15:166–172PubMedGoogle Scholar
  41. 41.
    Gusbeth-Tatomir P, Boisteanu D, Seica A et al (2007) Sleep disorders: a systematic review of an emerging major clinical issue in renal patients. Int Urol Nephrol 39:1217–1226. doi: 10.1007/s11255-007-9262-2 PubMedCrossRefGoogle Scholar
  42. 42.
    Iliescu EA, Coo H, McMurray MH et al (2003) Quality of sleep and health-related quality of life in haemodialysis patients. Nephrol Dial Transplant 18:126–132. doi: 10.1093/ndt/18.1.126 PubMedCrossRefGoogle Scholar
  43. 43.
    Iliescu EA, Yeates KE, Holland DC (2004) Quality of sleep in patients with chronic kidney disease. Nephrol Dial Transplant 19:95–99. doi: 10.1093/ndt/gfg423 PubMedCrossRefGoogle Scholar
  44. 44.
    Parker KP (2003) Sleep disturbances in dialysis patients. Sleep Med Rev 7:131–143. doi: 10.1053/smrv.2001.0240 PubMedCrossRefGoogle Scholar
  45. 45.
    Parker KP, Kutner NG, Bliwise DL et al (2003) Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis. Health Qual Life Outcomes 1:68. doi: 10.1186/1477-7525-1-68 PubMedCrossRefGoogle Scholar
  46. 46.
    Sabbatini M, Minale B, Crispo A et al (2002) Insomnia in maintenance haemodialysis patients. Nephrol Dial Transplant 17:852–856. doi: 10.1093/ndt/17.5.852 PubMedCrossRefGoogle Scholar
  47. 47.
    Mucsi I, Molnar MZ, Rethelyi J et al (2004) Sleep disorders and illness intrusiveness in patients on chronic dialysis. Nephrol Dial Transplant 19:1815–1822. doi: 10.1093/ndt/gfh130 PubMedCrossRefGoogle Scholar
  48. 48.
    Eryavuz N, Yuksel S, Acarturk G et al (2008) Comparison of sleep quality between hemodialysis and peritoneal dialysis patients. Int Urol Nephrol 40:785–791. doi: 10.1007/s11255-008-9359-2 PubMedCrossRefGoogle Scholar
  49. 49.
    Mucsi I, Molnar MZ, Ambrus C et al (2005) Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis. Nephrol Dial Transplant 20:571–577. doi: 10.1093/ndt/gfh654 PubMedCrossRefGoogle Scholar
  50. 50.
    Walsh JK (2004) Clinical and socioeconomic correlates of insomnia. J Clin Psychiatry 65(Suppl 8):13–19PubMedGoogle Scholar
  51. 51.
    Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6:97–111. doi: 10.1053/smrv.2002.0186 PubMedCrossRefGoogle Scholar
  52. 52.
    Hatoum HT, Kong SX, Kania CM et al (1998) Insomnia, health-related quality of life and healthcare resource consumption. A study of managed-care organisation enrollees. Pharmacoeconomics 14:629–637. doi: 10.2165/00019053-199814060-00004 PubMedCrossRefGoogle Scholar
  53. 53.
    Chevalier H, Los F, Boichut D et al (1999) Evaluation of severe insomnia in the general population: results of a European multinational survey. J Psychopharmacol 13:S21–S24PubMedGoogle Scholar
  54. 54.
    Mallon L, Broman JE, Hetta J (2000) Relationship between insomnia, depression, and mortality: a 12-year follow-up of older adults in the community. Int Psychogeriatr 12:295–306. doi: 10.1017/S1041610200006414 PubMedCrossRefGoogle Scholar
  55. 55.
    Mallon L, Broman JE, Hetta J (2002) Sleep complaints predict coronary artery disease mortality in males: a 12-year follow-up study of a middle-aged Swedish population. J Intern Med 251:207–216. doi: 10.1046/j.1365-2796.2002.00941.x PubMedCrossRefGoogle Scholar
  56. 56.
    Novak M, Mucsi I, Shapiro CM et al (2004) Increased utilization of health services by insomniacs—an epidemiological perspective. J Psychosom Res 56:527–536. doi: 10.1016/j.jpsychores.2004.02.007 PubMedCrossRefGoogle Scholar
  57. 57.
    Ohayon M (1996) Epidemiological study on insomnia in the general population. Sleep 19:S7–S15PubMedGoogle Scholar
  58. 58.
    Ohayon MM, Roberts RE (2001) Comparability of sleep disorders diagnoses using DSM-IV and ICSD classifications with adolescents. Sleep 24:920–925PubMedGoogle Scholar
  59. 59.
    Ohayon MM, Roth T (2001) What are the contributing factors for insomnia in the general population? J Psychosom Res 51:745–755. doi: 10.1016/S0022-3999(01)00285-9 PubMedCrossRefGoogle Scholar
  60. 60.
    Ohayon MM, Guilleminault C, Paiva T et al (1997) An international study on sleep disorders in the general population: methodological aspects of the use of the Sleep-EVAL system. Sleep 20:1086–1092PubMedGoogle Scholar
  61. 61.
    Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2003) The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res 55:263–267. doi: 10.1016/S0022-3999(02)00604-9 PubMedCrossRefGoogle Scholar
  62. 62.
    Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2000) Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res 48:555–560. doi: 10.1016/S0022-3999(00)00095-7 PubMedCrossRefGoogle Scholar
  63. 63.
    Sabbatini M, Crispo A, Pisani A et al (2005) Sleep quality in renal transplant patients: a never investigated problem. Nephrol Dial Transplant 20:194–198. doi: 10.1093/ndt/gfh604 PubMedCrossRefGoogle Scholar
  64. 64.
    Novak M, Molnar MZ, Ambrus C et al (2006) Chronic insomnia in kidney transplant recipients. Am J Kidney Dis 47:655–665. doi: 10.1053/j.ajkd.2005.12.035 PubMedCrossRefGoogle Scholar
  65. 65.
    Molnar MZ, Novak M, Ambrus C et al (2005) Anemia in kidney transplanted patients. Clin Transplant 19:825–833PubMedGoogle Scholar
  66. 66.
    Eryilmaz MM, Ozdemir C, Yurtman F et al (2005) Quality of sleep and quality of life in renal transplantation patients. Transplant Proc 37:2072–2076. doi: 10.1016/j.transproceed.2005.03.084 PubMedCrossRefGoogle Scholar
  67. 67.
    Redline S, Strohl KP (1998) Recognition and consequences of obstructive sleep apnea hypopnea syndrome. Clin Chest Med 19:1–19. doi: 10.1016/S0272-5231(05)70428-7 PubMedCrossRefGoogle Scholar
  68. 68.
    Young T, Palta M, Dempsey J et al (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235. doi: 10.1056/NEJM199304293281704 PubMedCrossRefGoogle Scholar
  69. 69.
    Baldwin CM, Griffith KA, Nieto FJ et al (2001) The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study. Sleep 24:96–105PubMedGoogle Scholar
  70. 70.
    de Oliveira Rodrigues CJ, Marson O, Tufic S et al (2005) Relationship among end-stage renal disease, hypertension, and sleep apnea in nondiabetic dialysis patients. Am J Hypertens 18:152–157. doi: 10.1016/j.amjhyper.2004.08.028 PubMedCrossRefGoogle Scholar
  71. 71.
    Hui DS, Wong TY, Li TS et al (2002) Prevalence of sleep disturbances in Chinese patients with end stage renal failure on maintenance hemodialysis. Med Sci Monit 8:CR331–CR336PubMedGoogle Scholar
  72. 72.
    Chen WC, Lim PS, Wu WC et al (2006) Sleep behavior disorders in a large cohort of Chinese (Taiwanese) patients maintained by long-term hemodialysis. Am J Kidney Dis 48:277–284. doi: 10.1053/j.ajkd.2006.04.079 PubMedCrossRefGoogle Scholar
  73. 73.
    Hui DS, Wong TY, Ko FW et al (2000) Prevalence of sleep disturbances in Chinese patients with end-stage renal failure on continuous ambulatory peritoneal dialysis. Am J Kidney Dis 36:783–788. doi: 10.1053/ajkd.2000.17664 PubMedCrossRefGoogle Scholar
  74. 74.
    Wadhwa NK, Seliger M, Greenberg HE et al (1992) Sleep related respiratory disorders in end-stage renal disease patients on peritoneal dialysis. Perit Dial Int 12:51–56PubMedGoogle Scholar
  75. 75.
    Merlino G, Piani A, Dolso P et al (2006) Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transplant 21:184–190. doi: 10.1093/ndt/gfi144 PubMedCrossRefGoogle Scholar
  76. 76.
    Walker S, Fine A, Kryger MH (1995) Sleep complaints are common in a dialysis unit. Am J Kidney Dis 26:751–756. doi: 10.1016/0272-6386(95)90438-7 PubMedCrossRefGoogle Scholar
  77. 77.
    Molnar MZ, Szentkiralyi A, Lindner A et al (2007) High prevalence of patients with a high risk for obstructive sleep apnoea syndrome after kidney transplantation—association with declining renal function. Nephrol Dial Transplant 22:2686–2692. doi: 10.1093/ndt/gfm246 PubMedCrossRefGoogle Scholar
  78. 78.
    Markou N, Kanakaki M, Myrianthefs P et al (2006) Sleep-disordered breathing in nondialyzed patients with chronic renal failure. Lung 184:43–49. doi: 10.1007/s00408-005-2563-2 PubMedCrossRefGoogle Scholar
  79. 79.
    Hanly PJ, Pierratos A (2001) Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N Engl J Med 344:102–107. doi: 10.1056/NEJM200101113440204 PubMedCrossRefGoogle Scholar
  80. 80.
    Langevin B, Fouque D, Léger P et al (1993) Sleep apnea syndrome and end-stage renal disease. Cure after renal transplantation. Chest 103:1330–1335. doi: 10.1378/chest.103.5.1330 PubMedCrossRefGoogle Scholar
  81. 81.
    Auckley DH, Schmidt-Nowara W, Brown LK (1999) Reversal of sleep apnea hypopnea syndrome in end-stage renal disease after kidney transplantation. Am J Kidney Dis 34:739–744. doi: 10.1016/S0272-6386(99)70401-4 PubMedCrossRefGoogle Scholar
  82. 82.
    Beecroft JM, Zaltzman J, Prasad R et al (2007) Impact of kidney transplantation on sleep apnoea in patients with end-stage renal disease. Nephrol Dial Transplant 22:3028–3033. doi: 10.1093/ndt/gfm309 PubMedCrossRefGoogle Scholar
  83. 83.
    Koczy A, Molnar M, Vamos E et al (2006) Obstructive sleep apnea syndrome is independently associated with worse quality of life in transplanted patients. The QRL Journal:A-68, Abstract #1173Google Scholar
  84. 84.
    Walters AS (1995) Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord 10:634–642. doi: 10.1002/mds.870100517 PubMedCrossRefGoogle Scholar
  85. 85.
    Allen RP, Picchietti D, Hening WA et al (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. doi: 10.1016/S1389-9457(03)00010-8 PubMedCrossRefGoogle Scholar
  86. 86.
    Stiasny K, Oertel WH, Trenkwalder C (2002) Clinical symptomatology and treatment of restless legs syndrome and periodic limb movement disorder. Sleep Med Rev 6:253–265. doi: 10.1053/smrv.2001.0193 PubMedCrossRefGoogle Scholar
  87. 87.
    Nichols DA, Allen RP, Grauke JH et al (2003) Restless legs syndrome symptoms in primary care: a prevalence study. Arch Intern Med 163:2323–2329. doi: 10.1001/archinte.163.19.2323 PubMedCrossRefGoogle Scholar
  88. 88.
    Tan EK, Seah A, See SJ et al (2001) Restless legs syndrome in an Asian population: a study in Singapore. Mov Disord 16:577–579. doi: 10.1002/mds.1102 PubMedCrossRefGoogle Scholar
  89. 89.
    Lavigne GJ, Montplaisir JY (1994) Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep 17:739–743PubMedGoogle Scholar
  90. 90.
    Phillips B, Young T, Finn L et al (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160:2137–2141. doi: 10.1001/archinte.160.14.2137 PubMedCrossRefGoogle Scholar
  91. 91.
    Berger K, Luedemann J, Trenkwalder C et al (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164:196–202. doi: 10.1001/archinte.164.2.196 PubMedCrossRefGoogle Scholar
  92. 92.
    Benz RL, Pressman MR, Hovick ET et al (1999) A preliminary study of the effects of correction of anemia with recombinant human erythropoietin therapy on sleep, sleep disorders, and daytime sleepiness in hemodialysis patients (The SLEEPO study). Am J Kidney Dis 34:1089–1095. doi: 10.1016/S0272-6386(99)70015-6 PubMedCrossRefGoogle Scholar
  93. 93.
    O’Keeffe ST, Gavin K, Lavan JN (1994) Iron status and restless legs syndrome in the elderly. Age Ageing 23:200–203. doi: 10.1093/ageing/23.3.200 PubMedCrossRefGoogle Scholar
  94. 94.
    Sloand JA, Shelly MA, Feigin A et al (2004) A double-blind, placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syndrome. Am J Kidney Dis 43:663–670. doi: 10.1053/j.ajkd.2003.11.021 PubMedCrossRefGoogle Scholar
  95. 95.
    Takaki J, Nishi T, Nangaku M et al (2003) Clinical and psychological aspects of restless legs syndrome in uremic patients on hemodialysis. Am J Kidney Dis 41:833–839. doi: 10.1016/S0272-6386(03)00031-3 PubMedCrossRefGoogle Scholar
  96. 96.
    Unruh ML, Levey AS, D’Ambrosio C et al (2004) Restless legs symptoms among incident dialysis patients: association with lower quality of life and shorter survival. Am J Kidney Dis 43:900–909. doi: 10.1053/j.ajkd.2004.01.013 PubMedCrossRefGoogle Scholar
  97. 97.
    Gigli GL, Adorati M, Dolso P et al (2004) Restless legs syndrome in end-stage renal disease. Sleep Med 5:309–315. doi: 10.1016/j.sleep.2004.01.014 PubMedCrossRefGoogle Scholar
  98. 98.
    Molnar MZ, Novak M, Ambrus C et al (2005) Restless legs syndrome in patients after renal transplantation. Am J Kidney Dis 45:388–396. doi: 10.1053/j.ajkd.2004.10.007 PubMedCrossRefGoogle Scholar
  99. 99.
    Winkelmann J, Stautner A, Samtleben W et al (2002) Long-term course of restless legs syndrome in dialysis patients after kidney transplantation. Mov Disord 17:1072–1076. doi: 10.1002/mds.10231 PubMedCrossRefGoogle Scholar
  100. 100.
    Benz RL, Pressman MR, Hovick ET et al (2000) Potential novel predictors of mortality in end-stage renal disease patients with sleep disorders. Am J Kidney Dis 35:1052–1060. doi: 10.1016/S0272-6386(00)70039-4 PubMedCrossRefGoogle Scholar
  101. 101.
    Molnar MZ, Szentkiralyi A, Lindner A et al (2007) Restless legs syndrome and mortality in kidney transplant recipients. Am J Kidney Dis 50:813–820. doi: 10.1053/j.ajkd.2007.08.003 PubMedCrossRefGoogle Scholar
  102. 102.
    Beecroft JM, Zaltzman J, Prasad GV et al (2008) Improvement of periodic limb movements following kidney transplantation. Nephron Clin Pract 109:c133–c139. doi: 10.1159/000145456 PubMedCrossRefGoogle Scholar
  103. 103.
    Molnar MZ, Novak M, Szeifert L et al (2007) Restless legs syndrome, insomnia, and quality of life after renal transplantation. J Psychosom Res 63:591–597. doi: 10.1016/j.jpsychores.2007.06.007 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2009

Authors and Affiliations

  • Miklos Zsolt Molnar
    • 1
    • 2
    • 3
  • Marta Novak
    • 1
    • 4
  • Istvan Mucsi
    • 1
    • 5
  1. 1.Institute of Behavioral SciencesSemmelweis UniversityBudapestHungary
  2. 2.Department of Transplantation and SurgerySemmelweis UniversityBudapestHungary
  3. 3.Fresenius Medical Care Dialysis CenterSemmelweis UniversityBudapestHungary
  4. 4.Department of Psychiatry, University Health NetworkUniversity of TorontoTorontoCanada
  5. 5.1st Department of Internal MedicineSemmelweis UniversityBudapestHungary

Personalised recommendations