Clinical and epidemiological evaluation of sleep disorders in chronic kidney patients at a dialysis center in Amazonas, Brazil

Background: Sleep disorders range from simple insomnia to more severe conditions, affecting overall bodily function. In Brazil, about 20 million people report some form of sleep disorders. Studies show a strong relationship between sleeping shorter or longer than normal with the prevalence and severity of chronic diseases such as hypertension, diabetes and cardiovascular diseases. Among patients with chronic kidney disease (CKD), up to 80% prevalence of sleep disorders can occur, which occurs both in patients in the early stages and in patients on maintenance dialysis. Therefore, it becomes relevant to gather clinical and epidemiological data from patients with CKD undergoing dialysis and correlate them with sleep disorders to assess whether there is evidence of a worse prognosis in these patients. Objective: Investigate the main sleep disorders in chronic kidney patients at a reference center for kidney diseases in Amazonas. Methods: The proposed study is a cross-sectional observational type and will be conducted at the Amazonas Kidney Disease Center, in Manaus, from December 2023 to March 2024. The sample will include CKD patients from the clinic, selected after approval by the Ethics Committee and signing of the Informed Consent Form. Patients underwent extensive data collection, including medical information, completion of sleep questionnaires such as Mini Sleep Questionnaire, Epworth Scale, Stop bang questionnaire and the diagnosis of Restless Legs Syndrome (RLS) that followed clinical criteria. Results: 100 CKD patients were evaluated, 63 (63.0%) of whom were male, 51 (51%) aged between 50-69 years, and 43 (43%) in the overweight range. Considering the MSQ, 60 (60%) have highly altered sleep; 43 (43%) have abnormal daytime sleepiness according to the Epworth scale; and, according to the Stop-Bang questionnaire, 41 (41%) are at high risk of developing sleep apnea. According to a previous assessment, of the 100 patients, seven (7%) were diagnosed with RLS. Of the seven patients, one (14.3%) had a mild degree, one (14.3%) had a moderate degree, four (57.1%) had a severe degree, and one (14.3%) had a very severe degree of RLS. There was no statistically significant evidence that sleep quality is related to the presence of RLS in chronic kidney disease patients (p> 0.05), considering the 5% level of significance. Conclusion: In this study, 60% of CKD patients through MSQ had alterations in sleep patterns, suggesting complexity in sleep conditions, with a variety of challenges ranging from daytime sleepiness to potential risks of sleep apnea. These findings underscore the importance of a holistic approach in managing the sleep of these patients, necessitating further studies for deeper exploration of this topic.