Sleep Disorders in CKD: A Review

Sleep disorders are highly prevalent in patients with chronic kidney disease (CKD) but are often underrecognized. The most common sleep disturbances in people with CKD include insomnia, sleep apnea syndrome, restless legs syndrome, and periodic limb movement disorder. The presence of sleep disorders in CKD can further worsen the burden of high morbidity and mortality in a patient population with already high mortality rates. The detection and management of sleep disorders in patients with CKD are often challenging because the classic symptoms of sleep disorders (poor concentration, daytime sleepiness, and insomnia) overlap with CKD symptomatology. The treatment of one symptom may have a negative impact on others; hence treatment of these disorders is challenging and may need to be individualized and modified based on the response to treatment and the development of adverse effects. However, treatment of sleep disorders may have significant clinical benefits, leading to improved health-related quality of life. This Review presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiology, diagnosis and treatment strategies.