Tang Sidney C W, Lai Kar Neng
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong - China.
J Nephrol. 2009 May-Jun;22(3):318-25.
Sleep disturbances in chronic peritoneal dialysis (PD) patients are increasingly widely recognized. These include changes in sleep architecture, sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder and excessive daytime sleepiness. Some of these entities will be addressed in this review. The study tools for detecting sleep-related disorders in PD patients range from self-reported questionnaires (subjective) to standard overnight polysomnographic measurements (objective). Both these tools identify a high prevalence (over 50%) of sleep-related disorders among dialysis patients. Among these, sleep apnea syndrome is one of the most widely reported sleep-related disorders in PD. Sleep apnea in PD may be attributed to chronic fluid overload and uremia, leading to both obstructive and central forms of apneas. The exact underlying pathophysiology, however, is complex and likely involves a combination of multiple factors. There are preliminary data that nocturnal PD may be advantageous over conventional continuous ambulatory peritoneal dialysis in correcting sleep apnea associated with PD. Randomized studies are needed for confirmation.
慢性腹膜透析（PD）患者的睡眠障碍日益受到广泛关注。这些睡眠障碍包括睡眠结构改变、睡眠呼吸暂停综合征、不宁腿综合征、周期性肢体运动障碍和日间过度嗜睡。本综述将探讨其中一些问题。检测PD患者睡眠相关障碍的研究工具范围从自我报告问卷（主观）到标准的夜间多导睡眠图测量（客观）。这两种工具都显示透析患者中睡眠相关障碍的患病率很高（超过50%）。其中，睡眠呼吸暂停综合征是PD中报告最广泛的睡眠相关障碍之一。PD中的睡眠呼吸暂停可能归因于慢性液体过载和尿毒症，导致阻塞性和中枢性两种形式的呼吸暂停。然而，确切的潜在病理生理学很复杂，可能涉及多种因素的综合作用。有初步数据表明，夜间PD在纠正与PD相关的睡眠呼吸暂停方面可能比传统的持续性非卧床腹膜透析更具优势。需要进行随机研究来证实这一点。
