title: Sleep disturbance in pediatric patients on automated peritoneal dialysis.
abstract: OBJECTIVE
  There are few reports describing sleep disturbance (SD) in children on automated peritoneal dialysis (APD), and they are mostly based on the application of questionnaires. As far as we know, only two studies used polysomnography (PSG), the gold standard for the diagnosis of SD. This is the first study assessing SD in children with chronic kidney disease (CKD) on APD in our country.
  
  
  METHODS
  This was an observational and descriptive study. Children up to 18 years of age who had undergone APD for a minimum of three months were considered eligible. Exclusion criteria were diabetes, neurologic disorders and sedative/hypnotic therapy. PSG was performed while the children were on their usual cycler nocturnal dialysis regimen. A questionnaire was completed on the same day. Informed, written consent was provided by all participants.
  
  
  RESULTS
  Eight children on APD were studied. The median age was 10 years (range, 1-18 years) and the mean body mass index z-score was -0.35 (±0.71). The average duration on dialysis was 8.4 months. SD was noted in five (62.5%) patients. The results of PSG showed decreased sleep efficiency (81.05 ± 0.09%) and latency (13.6 ± 11.6 min), increased awake time (23.08% of total sleep time (TST) ± 14.3), apnea/hypopnea index (1.8/h ± 1.9) and desaturation index (4.5 ± 3.7). Periodic leg movements index average was normal (0.78/h ± 0.77). Subjective data obtained by the sleep questionnaire underestimated PSG findings.
  
  
  CONCLUSIONS
  Our study shows that SD was present in more than half of children on PD. This result, in a small sample of patients, alerts to the need for systematic screening for sleep problems in children with CKD with a low threshold for a formal PSG.
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, CHLN - Academic Medical Centre of Lisbon, Lisbon, Portugal. Electronic address: claudia_lou_gomes@hotmail.com.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Gomes
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, CHLN - Academic Medical Centre of Lisbon, Lisbon, Portugal.
authors.forename: Lia
authors.initials: L
authors.lastname: Oliveira
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, CHLN - Academic Medical Centre of Lisbon, Lisbon, Portugal; Respiratory Unit, Department of Pediatrics, Hospital de Santa Maria, CHLN - Academic Medical Centre of Lisbon, Lisbon, Portugal.
authors.forename: Rosário
authors.initials: R
authors.lastname: Ferreira
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, CHLN - Academic Medical Centre of Lisbon, Lisbon, Portugal; Nephrology and Renal Transplantation Unit, Department of Pediatrics, Hospital de Santa Maria, CHLN - Academic Medical Centre of Lisbon, Lisbon, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Simão
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods*; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: Children; Peritoneal dialysis; Polysomnography; Sleep disturbance