title: Prevalence and correlates of insomnia and obstructive sleep apnea in chronic kidney disease.
abstract: BACKGROUND
  Poor sleep quality, insomnia, and restless legs syndrome (RLS) and sleep apnea are common in patients with chronic kidney disease (CKD). Clinical correlates of these problems are poorly understood.
  
  
  OBJECTIVE
  This study was to find out the prevalence and correlates of insomnia and subjects with 'high risk for obstructive sleep apnea (OSA)' in adults with chronic kidney disease.
  
  
  METHODS
  One hundred and four adults with CKD were included. Their demographic data, details regarding kidney disease and hemodialysis (HD) were recorded. Presence of insomnia and its severity was assessed. They were screened for sleep apnea using a validated questionnaire.
  
  
  RESULTS
  Average age was 54.17 (± 12.96) years. 89.4% had stage 5 nephropathy and 78.8% subjects were on regular HD. Males outnumbered females. Insomnia was reported by 35.5%. Among these, 50% had chronic insomnia. Insomnia subjects had higher prevalence of diabetes (P = 0.01) and depression (P < 0.001). Fifty-one percent subjects were at "high risk for sleep apnea". They had higher prevalence of diabetes (P < 0.001), coronary disease (P = 0.02), insomnia (P = 0.008), and experienced daytime symptoms of insomnia (P < 0.001). However, in the logistic regression, only male gender (odds ratio, OR = 13.59) and daytime symptoms of insomnia (OR = 7.34) were found to be associated with "higher risk for sleep apnea".
  
  
  CONCLUSIONS
  Insomnia was prevalent in CKD. Nearly half of these patients are at high risk for sleep apnea and a third of them suffer from insomnia. Hence, these patients should be screened for sleep disorders.
authors.affiliation: Department of Nephrology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Shahbaj
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: - Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Manan
authors.initials: M
authors.lastname: Gupta
authors.affiliation: - Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Gupta
authors.affiliation: - Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Dhyani
keywords: Chronic kidney disease; Hemodialysis; Insomnia; Obstructive sleep apnea