Sleep disturbances in children and adolescents with non-dialysis-dependent chronic kidney disease.

摘要

BACKGROUND: While studies have shown sleep disorders to be common in adults with chronic kidney disease (CKD), pediatric data are scarce. OBJECTIVE: To characterize the prevalence of sleep disorders among children and adolescents with non-dialysis-dependent CKD. DESIGN: Prospective, questionnaire-based, cross-sectional study. SETTING: Tertiary pediatric nephrology center. PARTICIPANTS: Children aged 6 to 18 years with non-dialysis-dependent CKD. Those with renal transplants were also considered to have CKD and were included, provided it was at least 3 months after the transplant. INTERVENTIONS: A validated pediatric sleep questionnaire. OUTCOME MEASURES: Four domains of sleep disturbance were assessed: sleep-disordered breathing, restless leg syndrome/paroxysmal leg movement (RLS/PLM), insomnia, and excessive daytime sleepiness. Positive responses to any of these signified the presence of a sleep disorder. RESULTS: A total of 49 non-dialysis-dependent children (30 with non-renal transplant CKD and 19 with post-renal transplant CKD; median age, 14 years; interquartile range, 6-18 years) were administered the pediatric sleep questionnaire; 71% (n = 35) of the patients were male; 37% (n = 18) were identified as having a sleep disorder; 40% (n = 12) were in the nontransplant CKD group and 32% (n = 6) in the transplant CKD group. The most common type of sleep disorder was RLS/PLM, affecting 27% (n = 8) in the nontransplant CKD group and 32% (n = 6) in the transplant CKD group. There was no correlation between stage of CKD and prevalence of sleep problems (P = .22). CONCLUSIONS: Disordered sleep was identified in more than one-third of our study population, and the most common type was RLS/PLM. Pediatricians should be aware of the relatively high incidence of sleep disorder among children and adolescents with CKD.