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Published on: September 22, 2020
Sleep disturbances in children and adolescents with non-dialysis-dependent chronic kidney disease
Rajiv Sinha1, Ira D Davis, Mina Matsuda-Abedini
1Department of Paediatric Nephrology, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada. rajivsinha_in@yahoo.com
Insights
Sleep disorders are common in children with chronic kidney disease (CKD), affecting over a third of patients. Restless legs syndrome/paroxysmal leg movement (RLS/PLM) was the most frequent sleep issue identified.
Area of Science:
- Pediatric Nephrology
- Sleep Medicine
- Chronic Disease Management
Background:
- Limited data exist on sleep disorders in pediatric chronic kidney disease (CKD) patients.
- Adult CKD studies indicate a high prevalence of sleep disturbances.
- This study addresses the pediatric knowledge gap.
Purpose of the Study:
- To determine the prevalence of sleep disorders in children and adolescents with non-dialysis-dependent CKD.
- To identify common types of sleep disturbances in this population.
- To inform clinical awareness and management strategies.
Main Methods:
- A prospective, cross-sectional study utilizing a validated pediatric sleep questionnaire.
- Participants included children aged 6-18 years with non-dialysis-dependent CKD, including those with renal transplants (≥3 months post-transplant).
- Sleep disorders assessed included sleep-disordered breathing, restless leg syndrome/paroxysmal leg movement (RLS/PLM), insomnia, and excessive daytime sleepiness.
Main Results:
- Out of 49 participants, 37% (n=18) had a diagnosed sleep disorder.
- Restless legs syndrome/paroxysmal leg movement (RLS/PLM) was the most prevalent sleep disorder, affecting 27% in the non-transplant CKD group and 32% in the transplant CKD group.
- No significant correlation was found between CKD stage and the prevalence of sleep problems (P = .22).
Conclusions:
- Over one-third of children and adolescents with non-dialysis-dependent CKD experience sleep disorders.
- RLS/PLM is the most common sleep disturbance identified in this pediatric cohort.
- Pediatricians should screen for sleep disorders in children with CKD due to their high incidence.
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.
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