Effects of sleep apnea and kidney dysfunction on objective sleep quality in nondialyzed patients with chronic kidney disease: an ESADA study

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dc.contributor.authorMarrone, Oreste
dc.contributor.authorCibella, Fabio
dc.contributor.authorRoisman, Gabriel
dc.contributor.authorSliwinski, Pawel
dc.contributor.authorJoppa, Pavol
dc.contributor.authorBasoglu, Ozen K.
dc.contributor.authorVerbraecken, Johan
dc.date.accessioned2021-05-03T20:37:01Z
dc.date.available2021-05-03T20:37:01Z
dc.date.issued2020
dc.departmentEge Üniversitesien_US
dc.description.abstractStudy Objectives: Patients with chronic kidney disease (CKD) often report poor sleep quality, but they commonly exhibit OSA. The aim of this study was to evaluate the influence of OSA severity and of estimated glomerular filtration rate impairment on objective sleep quality in nondialyzed patients with CKD, defined as an estimated glomerular filtration rate <60 mlimin/1.73m(2). Methods: Polysomnographic sleep characteristics were compared between patients with (n = 430) and without CKD (n = 6,639) in the European Sleep Apnea Database cohort. Comparisons were repeated in 375 patients with CKD and 375 control patients without CKD matched for sleep center, age, sex, and AHI, and in 310 matched CKD and non-CKD patients without psychiatric disturbances. Results: Among all patients with and without CKD, total sleep time was similar but sleep stage N1 (median 8.7% [IQR 4.8-18.0] vs 6.7% [3.6-12.7], respectively) and sleep stage R (12.6% [6.8-17.7] vs 14.2% [8.8-19.8], respectively) significantly differed (P <.0001). No difference in sleep characteristics was observed between matched patients either with or without psychiatric disturbances. After subdividing the matched patients according to AHI tertile (<25, >= 25 to <49, and >= 49 events/h) and estimated glomerular filtration rate (>= 60, 45 to <60, <45 mL/min/1.73m(2)), we found a significant effect of AHI on sleep stages N2, N3, and R (P <.001), but there was no effect of CKD. Conclusions: in nondialyzed patients with CKD, objective sleep quality is influenced similarly by AHI as in patients without CKD but is not affected by CKD severity. Previously reported poor sleep quality in CKD may partly result from the high prevalence of OSA in CKD.en_US
dc.description.sponsorshipEuropean Union COST Action B26; European Respiratory Society; ResMed Foundation; Philips Respironics Foundation; ResMed; Philips Respironics; BayerBayer AG; Vivisol; Medicair Italyen_US
dc.description.sponsorshipAll authors have seen and approved the manuscript. By submitting the manuscript to the journal, the authors affirm that it is an original manuscript, is unpublished work if not as an abstract, and is not under consideration elsewhere. Work for this study was performed at institutions listed in the acknowledgments. This study was funded by support for the European Sleep Apnea Database network from the European Union COST Action B26 and the European Respiratory Society-funded Clinical Research Collaboration (funding 2015-2020). Unrestricted seed grants from the ResMed Foundation and the Philips Respironics Foundation for the establishment of the database in 2007 and 2011 are gratefully acknowledged. The European Sleep Apnea Database has a scientific collaboration with Bayer AG. O.M., F.C, G.R., P.S., P.J., O.K.B., I. B., S.S., A.P., R.S., and J.V. do not have any financial interests or connections, direct or indirect, or other situations that might raise the question of bias in the work reported or the conclusions, implications, or opinions stated. J.H. reports grants from ResMed, Philips Respironics, Bayer, and the European Respiratory Society related to maintenance of the database on behalf of the European Sleep Apnea Database group. L.G. reports a collaboration between the European Sleep Apnea Database network and Bayer. M.R.B. reports research financial support by Vivisol and Medicair Italy and honoraria from ResMed and Bioproject.en_US
dc.identifier.doi10.5664/jcsm.8542en_US
dc.identifier.endpage1481en_US
dc.identifier.issn1550-9389
dc.identifier.issn1550-9397
dc.identifier.issue9en_US
dc.identifier.pmid32364929en_US
dc.identifier.startpage1475en_US
dc.identifier.urihttps://doi.org/10.5664/jcsm.8542
dc.identifier.urihttps://hdl.handle.net/11454/70318
dc.identifier.volume16en_US
dc.identifier.wosWOS:000598073400008en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAmer Acad Sleep Medicineen_US
dc.relation.ispartofJournal of Clinical Sleep Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectchronic kidney diseaseen_US
dc.subjectestimated glomerular filtration rateen_US
dc.subjectsleep apneaen_US
dc.subjectsleep qualityen_US
dc.titleEffects of sleep apnea and kidney dysfunction on objective sleep quality in nondialyzed patients with chronic kidney disease: an ESADA studyen_US
dc.typeArticleen_US

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