Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030429980
Publisher: Springer International Publishing

27.3.2.3 End-Stage Renal Disease

Sleep-disordered breathing (SDB) is increasingly recognized amongst patients with end-stage renal disease (ESRD). OSA is the most commonly reported disorder, followed by CSA. Nevertheless, the pathogenesis of sleep apnoea in ESRD remains unclear. Previous work on features of sleep apnoea in ESRD patients suggested that fluid retention seems to play a central role and its pathogenesis may be related to both upper airway occlusion and destabilization of central respiratory control.

Concerning CSA, there are a few studies in the literature addressing therapy aspects. Nocturnal haemodialysis seems to be superior in reducing CSA over conventional haemodialysis during daytime. Regarding subjective sleep assessments, improved sleep quality was found in the prospective pre–post intervention studies and cohort studies, whilst no significant improvements were found in the randomized controlled trials. Oxygen therapy, CPAP and ASV have proven efficacious in reducing central events in ESRD [28].

No structured studies were found evaluating the effect of renal transplant in CSA.

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