Reduced renal function and sleep-disordered breathing in community-dwelling elderly men
Muna T Canales1, Brent C Taylor, Areef Ishani
1Division of Renal Diseases and Hypertension, Department of Medicine, University of Minnesota, Minneapolis, MN, USA. cana0033@umn.edu
Sleep Medicine
|September 27, 2008
Summary
Older men with reduced kidney function show higher rates of sleep-disordered breathing (SDB). Body mass index explains the link between cystatin-C and SDB, but Mayo Clinic-defined CKD is an independent risk factor.
Area of Science:
- Nephrology
- Sleep Medicine
- Cardiology
Background:
- Sleep-disordered breathing (SDB) is a potential risk factor for cardiovascular disease (CVD) and mortality in patients with chronic kidney disease (CKD).
- The relationship between early-stage kidney dysfunction and SDB remains unclear.
Purpose of the Study:
- To investigate the association between reduced renal function and SDB in older men.
- To determine if specific markers of kidney function are linked to SDB prevalence.
Main Methods:
- The study included 508 community-dwelling men (mean age 76.0 years) from the MrOS sleep study.
- Serum cystatin-C and creatinine were measured alongside overnight polysomnography.
- Chronic kidney disease (CKD) was defined using estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 via Cockcroft-Gault, MDRD, and Mayo Clinic formulae. Sleep-disordered breathing (SDB) was defined by a respiratory disturbance index (RDI) ≥ 15 events/h.
Main Results:
- Higher cystatin-C levels correlated with increased RDI (p=0.007), an association mediated by body mass index (BMI).
- After adjusting for confounders, CKD defined by the Mayo Clinic formula showed a significant association with SDB (OR 1.95, p=0.04).
- CKD definitions using Cockcroft-Gault or MDRD formulae did not show a significant association with SDB.
Conclusions:
- Elevated cystatin-C, indicating reduced renal function, is linked to higher SDB severity in older men, primarily due to BMI.
- Mayo Clinic-defined CKD is independently associated with a twofold increased odds of SDB.
- Reduced renal function may be an independent risk factor for SDB in the elderly male population.
Related Concept Videos
01:21Sleep Apnea
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:13Insufficient Sleep and Sleep Deprivation
Insufficient sleep refers to not getting the recommended amount of sleep for optimal functioning, even if it's just slightly less than needed. Sleep insufficiency may occur due to lifestyle choices, such as staying up late for social events or work, resulting in routinely getting less sleep than required. For example, consistently sleeping 6 hours when the body needs 7-9 hours can lead to cumulative effects on health and well-being.
Sleep deprivation is a more severe form of sleep loss...
Sleep deprivation is a more severe form of sleep loss...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:15REM Sleep Behavior Disorder
REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
RBD is significantly associated with...