Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study
Table 1
Characteristics of the study population.
All
Moderate to severe OSA (AHI ≥ 15/h)
No or mild OSA (AHI < 15/h)
104
58
46
Demographic
Age (y)
61.7 (14.9)
65.2 (14.1)
57.3 (14.8)
0.007
Male sex (, %)
66 (63.5)
44 (75.9)
22 (47.8)
0.003
Ethnicity (, %)
Caucasian
84 (80.8)
49 (84.5)
35 (76.1)
0.545
Asian
4 (3.8)
2 (3.4)
2 (4.4)
African
15 (15.4)
7 (12.1)
9 (19.6)
BMI (kg/m2)
26.1 (4.6)
26.6 (4.4)
25.5 (4.8)
0.217
Neck circumference (cm)
40.4 (4.4)
42.0 (3.8)
38.4 (4.3)
<0.001
Obesity (BMI ≥ 30 kg/m2) (, %)
21 (20.2)
13 (22.4)
8 (17.4)
0.526
Hypertension (, %)
95 (91.4)
54 (93.1)
41 (89.1)
0.474
Hemodialysis
Time on RRT (y) [median–IQR]
2.6 [0.9–6.5]
3.8 [1.2–10.3]
1.9 [0.9–3.8]
0.026
Residual diuresis (mL)
505 (751)
386 (563)
687 (953)
0.078
Interdialytic weight gain (kg)
0.97 (1.62)
0.99 (1.66)
0.95 (1.57)
0.908
HD duration per week (h)#
11.3 (1.0)
11.5 (0.8)
11.2 (1.2)
0.179
Morning HD shift (, %)
69 (66.4)
41 (70.7)
28 (60.9)
0.293
Hemodiafiltration (, %)#
25 (24.0)
12 (20.7)
13 (28.3)
0.369
HD access (, %):
Fistula
80 (76.9)
43 (74.1)
37 (80.4)
0.449
Catheter
24 (23.1)
15 (25.9)
9 (19.6)
eKt/V
1.51 (0.33)
1.47 (0.33)
1.56 (0.34)
0.203
Sleep
AHI (number/h) [median–IQR]
17.5 [7.0–40.0]
33.0 [22.0–52.0]
6.5 [4.0–10.0]
<0.001
ODI (number/h) [median–IQR]
18.0 [9.0–39.0]
38.0 [20.0–49.0]
9.0 [6.8–13.0]
<0.001
Epworth score [median–IQR]
5 [3–8]
5 [2–7]
5 [3–9]
0.247
Excessive daytime sleepiness (, %)
17 (16.4)
7 (12.1)
10 (21.7)
0.185
Sleep time (h) [median–IQR]
7 [6–8]
7 [6–8]
7 [6–8]
0.955
Poor sleep quality (, %)
31 (29.8)
18 (31.0)
13 (28.4)
0.759
Snoring (, %)
57 (54.8)
37 (63.8)
20 (43.5)
0.039
Unrefreshing sleep (, %)
35 (33.6)
19 (32.8)
16 (34.8)
0.828
Observed apneas (, %)
7 (6.7)
6 (10.3)
1 (2.2)
0.099
Restless legs syndrome (, %)
19 (19.0)
12 (22.2)
7 (15.2)
0.374
Use of sleep medications (, %)
17 (16.4)
7 (12.1)
10 (21.7)
0.285
Biology
Hemoglobin (g/L)
113.4 (12.3)
113.0 (12.9)
114.0 (11.8)
0.684
Phosphates (mmol/L)
1.49 (0.38)
1.43 (0.37)
1.57 (0.37)
0.072
Creatinine (mg/dL)
7.9 (2.3)
7.7 (2.4)
8.2 (2.2)
0.343
BUN (mg/dL)
54.6 (14.0)
54.0 (14.6)
55.2 (13.7)
0.730
Bicarbonates (mmol/L)
22.4 (2.4)
22.1 (2.7)
22.7 (2.0)
0.277
Values are expressed as mean (SD) if not otherwise specified. IQR: interquartile range. OSA: obstructive sleep apnea; BMI: body mass index; RRT: renal replacement therapy; HD: hemodialysis; eKt/V: hemodialysis efficacy, assessed using urea kinetic modelling; AHI: apnea/hypopnea index; ODI: oxygen desaturation index; BUN: blood urea nitrogen. #All patients on thrice weekly HD with a synthetic HD membrane (polysulfone or polyethersulfone).
