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September 7, 2009

Sleep Disturbances in Children and Adolescents With Non–Dialysis-Dependent Chronic Kidney Disease

Author Affiliations

Author Affiliations: Department of Paediatric Nephrology, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada (Drs Sinha and Matsuda-Abedini); Global Clinical Affairs, Renal Division, Baxter Healthcare Corporation, McGaw Park, Illinois (Dr Davis).

Arch Pediatr Adolesc Med. 2009;163(9):850-855. doi:10.1001/archpediatrics.2009.149

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.