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Central Sleep Apnea in Kidney Disease
Sushma M Dharia1, Mark L Unruh1, Lee K Brown1
1Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Seminars in Nephrology
|September 11, 2015
Summary
Chronic kidney disease (CKD) patients frequently experience sleep disorders like obstructive sleep apnea (OSA) and central sleep apnea (CSA). Treating CSA may improve health outcomes in CKD patients, with adaptive servo-ventilation as a potential key therapy.
Area of Science:
- Nephrology
- Pulmonology
- Sleep Medicine
Background:
- Sleep disorders are common in chronic kidney disease (CKD) patients.
- Obstructive sleep apnea (OSA) is linked to CKD causes and consequences.
- Central sleep apnea (CSA) is prevalent in CKD/end-stage renal disease (ESRD) but poorly understood.
Purpose of the Study:
- To review the relationship between CKD/ESRD and sleep disorders, particularly CSA.
- To highlight the underdiagnosis and undertreatment of CSA in CKD/ESRD.
- To discuss potential therapeutic strategies for CSA in CKD/ESRD.
Main Methods:
- Literature review of studies investigating sleep disorders in CKD/ESRD.
- Analysis of the impact of OSA and CSA on CKD progression and related comorbidities.
- Examination of treatment outcomes for CSA, drawing parallels from heart failure management.
Main Results:
- CSA is highly prevalent in CKD/ESRD and contributes to morbidity and mortality.
- Evidence suggests CSA treatment can improve outcomes in CKD/ESRD patients.
- Patients with co-existing CKD/ESRD and congestive heart failure are at higher risk for CSA.
Conclusions:
- CSA is a significant, often overlooked, contributor to poor outcomes in CKD/ESRD.
- Therapeutic interventions for CSA, including adaptive servo-ventilation, show promise.
- A multi-modal, stepped approach to CSA management is recommended for CKD/ESRD patients.
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