Abstract
Although sleep-disordered breathing (SDB) is a major problem in chronic dialysis patients because of its high incidence and poor prognosis, there are no established guidelines for treating SDB. We, therefore, estimated SDB using pulsoximetry the night before hemodialysis and the night after hemodialysis in 85 patients receiving chronic hemodialysis and evaluated the efficacy of oxygen therapy during sleep in 13 patients with SDB.
Forty-two of 85 patients showed a minimal oxygen saturation (SpO2) below 85%, in 17 patients lower SpO2 (<90%) persisted for more than 20 minutes and a increased oxygen desaturation index (ODI, ≥15) was observed in 12 patients. There were not significant differences in these three parameters on a comparison of findings before and after hemodialysis. The incidence of SDB was significantly higher in patients with cardiovascular disease. Subsequently, 13 patients received oxygen therapy during sleep and showed improvement of ODI from 16.88±11.58 to 6.49±5.75 (p<0.01), the duration of SpO2 below 90% decreased from 29.1±29.7min to 11.2±18.2min (p<0.01) and the minimal SpO2 increased from 72±8% to 80±11% (p<0.01).
Taken together, a high incidence of nocturnal oxygen desaturation due to SDB was observed in chronic dialysis patients, and we propose that oxygen therapy during sleep effectively reduces the frequency of apnea/hypopnea and improves hypoxemia during sleep in these patients.
