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

Arch Pediatr Adolesc Med. 2009 Sep;163(9):850-5. doi: 10.1001/archpediatrics.2009.149.

Abstract

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.

MeSH terms

  • Adolescent
  • Chi-Square Distribution
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation
  • Male
  • Prevalence
  • Prospective Studies
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / etiology*
  • Surveys and Questionnaires