Holley J L, Nespor S, Rault R
Renal-Electrolyte Division, University of Pittsburgh, Pennsylvania.
ASAIO Trans. 1991 Jul-Sep;37(3):M456-7.
Forty-eight chronic hemodialysis (HD) patients (pts) completed questionnaires that used linear analogue scales (LAS), yes/no responses, and demographic data collection to characterize sleep disorders. Twenty-five pts (52%) reported problems sleeping. These pts graded sleep problems significantly higher than those without sleep problems (6.5 +/- 3 vs. 1.8 +/- 2, p less than 0.001 by LAS). Those with sleep disorders were more likely to smoke cigarettes (13/25 vs. 6/23, p less than 0.05) and have bone pain (14/25 vs. 6/23, p less than 0.05). No differences among pts with and without sleep problems were seen in age, gender, time on dialysis, caffeine intake, pruritus, feelings of sadness, worry, or anxiety, or Kt/V values (1.5 +/- 0.2 vs. 1.4 +/- 0.2, p less than 0.13). Restless legs (84%), onset insomnia (76%), and nighttime (76%) and early A.M. waking (72%) characterized the sleep disorders; symptoms suggesting nocturnal myoclonus were less common (20%). We conclude that sleep disorders are common in HD pts and may be exacerbated by tobacco use, bone pain, and restless legs. Kt/V does not correlate with sleep disorders. Further examination of this problem, including formal sleep studies, is needed.
48例慢性血液透析（HD）患者完成了问卷调查，该问卷采用线性模拟量表（LAS）、是/否回答以及人口统计学数据收集来描述睡眠障碍。25例患者（52%）报告存在睡眠问题。这些患者对睡眠问题的评分显著高于无睡眠问题的患者（LAS评分分别为6.5±3和1.8±2，p<0.001）。有睡眠障碍的患者更有可能吸烟（13/25 vs. 6/23，p<0.05）和有骨痛（14/25 vs. 6/23，p<0.05）。在年龄、性别、透析时间、咖啡因摄入量、瘙痒、悲伤感、担忧或焦虑感或Kt/V值方面，有睡眠问题和无睡眠问题的患者之间未发现差异（分别为1.5±0.2和1.4±0.2，p<0.13）。不宁腿（84%）、入睡性失眠（76%）、夜间（76%）和清晨早醒（72%）是睡眠障碍的特征；提示夜间肌阵挛的症状较少见（20%）。我们得出结论，睡眠障碍在HD患者中很常见，可能因吸烟、骨痛和不宁腿而加重。Kt/V与睡眠障碍无关。需要对这个问题进行进一步检查，包括正式的睡眠研究。
