Sleep disorders in patient with chronic kidney disease: proposal for a clinical pathway

Abstract

Sleep disorders are common in all stages of chronic kidney disease and significantly affect the quality of life of these patients. The main causes of sleep disorders are pruritus, depression, restless legs syndrome and obstructive sleep apnea. To date, there is no defined strategy or expert consensus for the screening of sleep disorders in this population, nor any recommendation on a specific management strategy according to etiology. We propose to use the PROMIS-29 questionnaire, to which two questions have been added: “Do you scratch yourself? Do you snore?” The answers to these questions, together with the scores for the “Sleep disorders” (score ≥ 12), “Depression” (score ≥ 11), “Pain” (score ≥ 11) and “Fatigue” (score ≥ 14) domains make it possible to screen for sleep disorders, specify their etiology and refer patients for appropriate management. We suggest a standardized management strategy for each major orientation. This pathway, to be adapted according to the resources of each center, should lead to the diagnosis of more patients suffering from sleep disorders and improve their quality of life.