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Factors associated with sleep disorders in Chinese patients on continuous ambulatory peritoneal dialysis
Sing Leung Lui1, Flora Ng, Wai Kei Lo
1Division of Nephrology, University Department of Medicine, Tung Wah Hospital, Sheung Wan, Hong Kong, China. sllui@hkucc.hku.hk
Objective:
This study aimed at identifying factors that are associated with sleep disorders in Chinese patients on continuous ambulatory peritoneal dialysis (CAPD).
Study Design:
Questionnaire survey.
Setting:
Renal dialysis unit of a tertiary-care hospital.
Patients:
179 Chinese patients on CAPD.
Main Outcome Measures:
The quantity and quality of sleep were compared between CAPD patients with and without self-reported sleep disorders. Demographic variables, personality traits, behavioral factors, somatic symptoms, and clinical parameters were correlated with the presence of sleep disorders.
Results:
The mean age of the patients was 61 +/- 12 years and the male-to-female ratio was 1:1.3. The mean duration of CAPD was 47 +/- 42 months. 110 patients (61%) had self-reported sleep disorders. Among patients with self-reported sleep disorders, difficulty falling asleep was the most frequent complaint (74.5%), followed by frequent awakening (68%) and early morning waking (68%). The mean duration of sleep among these patients was 4.6 +/- 2.2 hours, versus 7.3 +/- 1.4 hours in patients without self- reported sleep disorders. Three personality traits (anxiety, worry, and sadness) and two somatic symptoms (bone pain and arthralgia) were the factors significantly associated with sleep disorders. Patients with sleep disorders also more frequently reported certain symptoms suggestive of sleep apnea. Demographic variables, behavioral factors (e.g., caffeine or alcohol intake), and clinical parameters (e.g., adequacy of dialysis, body mass index, hemoglobin, albumin, parathyroid hormone levels) did not differ between patients with and without sleep disorders.
Conclusions:
Sleep disorders are prevalent among Chinese CAPD patients. Personality traits (anxiety, worry, and sadness) and somatic symptoms (bone pain and arthralgia) were the factors significantly associated with sleep disorders in this patient population. Behavioral factors, demographic variables, and clinical parameters did not appear to predict sleep disorders. Further studies evaluating the impact of various psychological factors on sleep disorders among CAPD patients are warranted.