Sleep disorders and end-stage renal disease
Sleep disorders and end-stage renal disease
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DOI：
10.1097/mcp.0b013e3283130f96
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发表时间：
2008-11-01
影响因子：
3.3
通讯作者：
Hanly, Patrick
中科院分区：
文献类型：
--
作者：
Hanly, Patrick
综述的目的是提供终末期肾病(ESRD)患者睡眠障碍的患病率和临床重要性的最新研究，并强调其发病机制和治疗的最新发现。最近的发现尽管睡眠质量差在ESRD患者中很常见，但它被忽视了。除了导致生活质量受损外，睡眠不佳还会增加心血管死亡率。有证据表明，认知行为疗法可能有助于减少频繁使用催眠药，从而改善睡眠质量。终末期肾病患者睡眠呼吸暂停的临床表现与肾功能正常的患者相比有差异。ESRD患者睡眠呼吸暂停的发病机制似乎既与化疗敏感性增加有关，后者破坏了呼吸控制的稳定性，也与上呼吸道狭窄有关，后者易于在睡眠期间关闭呼吸道。虽然肾移植可以纠正周期性的腿部运动，但并不总是能纠正睡眠呼吸暂停。摘要睡眠障碍在终末期肾病患者中很常见，尽管近年来我们对其发病机制和临床表现的了解有所增加，但需要进一步研究以确定其对这类患者临床结局的影响。
Purpose of review To provide an update on the prevalence and clinical importance of sleep disorders in patients with end-stage renal disease (ESRD) and to highlight recent findings on their pathogenesis and treatment.Recent findings Although poor sleep quality is common in patients with ESRD, it is underrecognized. In addition to causing impaired quality of life, poor sleep is associated with increased cardiovascular mortality. There is evidence that sleep quality may be improved by cognitive-behavioral therapy that may help to reduce the frequent use of hypnotic medication. There are differences in the clinical presentation of sleep apnea in patients with ESRD compared with patients with normal renal function. The pathogenesis of sleep apnea in patients with ESRD appears to be related both to increased chemosensitivity, which destabilizes the control of breathing, and narrowing of the upper airway, which predisposes to closure of the airway during sleep. Although renal transplantation corrects periodic leg movements, it does not always correct sleep apnea.Summary Sleep disorders are common in patients with ESRD, Although our understanding of their pathogenesis and clinical presentation has grown in recent years, further research is required to determine their impact on clinical outcomes in this patient population.