Prevalence of sleep disturbances in Chinese patients with end-stage renal failure on continuous ambulatory peritoneal dialysis

Patients with end-stage renal failure (ESRF) are reported to have a high pr evalence of sleep disorders, such as daytime sleepiness, insomnia, restless legs syndrome (RLS), and obstructive sleep apnea syndrome (OSAS). However, there are few published data from Southeast Asia. A sleep questionnaire wa s administered to 201 patients (103 men) at the continuous ambulatory perit oneal dialysis (CAPD) outpatient clinic to assess sleep problems. Patients had a mean age of 56.7 +/- 12 (SD) years, with a mean body mass index (BMI) of 23.6 +/- 3.5 kg/m(2). Daytime sleepiness was the most frequent symptom (77.1%), and frequent awakening occurred in 69% of the patients. Sleep-onse t insomnia and sleep-maintenance insomnia occurred in 73% and 60% of the pa tients, respectively. Sixty-two percent of the patients reported symptoms o f RLS, which significantly correlated with sleep-onset insomnia (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.5 to 5.5; P = 0.001) and sleep- maintenance insomnia (OR, 2.1; 95% CI, 1.2 to 3.8; P = 0.014). The prevalen ce of OSAS was estimated by the frequency of the following symptoms: extrem ely loud snoring, 7 patients (3.5%); observed choking, 21 patients(10.5%); witnessed apnea, 11 patients (5.6%); snoring and witnessed apnea, 6 patient s (3%); disruptive snoring, 29 patients (14.4%); and disruptive snoring and witnessed apnea, 3 patients (1.5%). This questionnaire survey confirmed a high prevalence of daytime sleepiness, insomnia, and RLS in patients with E SRF undergoing CAPD but showed a relatively low prevalence of OSAS of up to 14.4%, which may be related to the low BMI of these patients with ESRF com pared with other populations. Whether this contributes to the overall bette r survival observed in some Asian patients with ESRF undergoing dialysis ne eds further investigation. (C) 2000 by the National Kidney Foundation, Inc.