Kidney disorders have been associated with a variety of sleep-related disorders. Therefore, researchers are placing greater emphasis on finding the role of chronic kidney disease (CKD) in the development of obstructive sleep apnea and restless legs syndrome. Unfortunately, the presence of other sleep-related disorders with CKDs and non-CKDs has not been investigated with the same clinical rigor. Recent studies have revealed that myriad of sleep disorders are associated with CKDs. Furthermore, there are a few non-CKD-related disorders that are associated with sleep disorders. Patients with kidney disorders are afflicted with various types of sleep disorders. At times, primary care providers may fail to identify the type of sleep disorder unless they are aware of the common co-existing sleep-related comorbidities to look for in patients with kidney disorders. In this narrative review, we will discuss the most common sleep disorders seen in patients with various kidney disorders with a primary focus on chronic kidney disease (CKD). The Kidney Disease Improving Global Outcomes (KDIGO) Work Group defines CKD as the presence of any prominent marker of kidney damage (such as albuminuria) or the glomerular filtration rate of less than 60 mL/min/1.73 m2 for a duration lasting 3 months or longer. Patients with insomnia typically experience difficulty falling asleep, staying asleep, and/or undesired sustained periods of wakefulness during normal sleep periods. Previous studies have identified both cognitive and physiological risk factors of insomnia. Among the physiological risk factors, kidney dysfunction likely leads to an imbalance of various metabolites influencing sleep, which might cause abnormalities in sleep. In patients with kidney disease, progression to CKD or end stage renal disease (ESRD) appears to be correlated with the development of various sleep disorders. Several studies have evaluated the effects of kidney disease on sleep disturbances and sleep disorders upon escalating to CKD or ESRD status. It leads to the development of CKD or ESRD which in turn causes disturbances in normal homeostasis affecting sleep. Several studies evaluating efficacy of dialysis in patients with CKD or ESRD reported findings that appear to strengthen the association between kidney dysfunction and sleep disorders.

Regards

Calvin Parker

Editorial Assistant

Journal of Nephrology and Urology