Sleep disorders in renal patients: a comparative analysis of dialysis and post-renal transplant outcomes

Sleep disorders are common among individuals with end-stage renal disease (ESRD) on dialysis and can persist after renal transplantation. This study aims to compare the association of sleep disorders between matched groups of patients with ESRD on dialysis and those who have undergone renal transplants. This is a clinic-based cross-sectional study conducted in patients with post-organ transplant and patients with ESRD on dialysis. The study involved, in addition to demographic data, administering structured sleep questionnaires, including the Epworth Sleepiness Scale (ESS), Berlin Questionnaire (BQ), STOP-BANG questionnaire, Pittsburgh Sleep Quality Index (PSQI), and questionnaires for insomnia and Restless legs syndrome (RLS). The study analyzed a total of 386 participants, comprising 227 (58.8%) patients with ESRD on dialysis and 159 (41.2%) who had undergone renal transplants. The results from the unmatched analysis revealed that renal transplantation patients have significantly lower odds of sleep disorders compared to ESRD on dialysis. After matching, the renal transplant remains significant associated with decreased odds of sleep disorders; insomnia (OR = 0.083, 95% CI: 0.030-0.231), EDS (OR = 0.034, 95% CI: 0.005-0.253), RLS (OR = 0.229, 95% CI: 0.106-0.493), poor sleep quality (OR = 0.265, 95% CI: 0.127-0.552), the likelihood of high risk for OSA using BQ (OR = 0.217, 95% CI: 0.119-0.395), high risk for OSA using STOP-BANG criteria (OR = 0.122, 95% CI: 0.063-0.236). There was no significant difference in sleep disorders due to the duration since transplant. This study confirms the ongoing effects of end-stage renal disease (ESRD) on sleep disorders in patients and highlights the benefits associated with renal transplantation in reducing the risk of OSA, insomnia, RLS, and improving overall sleep quality. However, a significant limitation of this study is that OSA was not assessed objectively through a formal sleep study.