Prevalence and characteristics of treatments for sleep disordered breathing in people receiving dialysis: a scoping review

TL;DR

This study finds that nearly 60% of people on dialysis have sleep apnoea, but there is limited evidence on effective treatments for this population.

Contribution

The study provides the first comprehensive scoping review on sleep disordered breathing prevalence and treatment in dialysis patients.

Findings

Sleep apnoea prevalence in dialysis patients is estimated at 59%.

Most cases are obstructive sleep apnoea, with moderate to severe cases at 44%.

There is insufficient evidence for effective treatments in this population.

Abstract

Individuals with kidney failure experience elevated cardiovascular risk, potentially worsened by the presence of sleep disordered breathing. Despite this association, prevalence of sleep apnoea, and evidence for effective treatments are poorly understood in people with kidney failure. This review examines sleep apnoea prevalence, types of sleep apnoea, and treatment interventions in people with kidney failure receiving dialysis.

Guidelines for scoping reviews were followed and the following databases were searched for both peer reviewed and grey literature: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, the Web of Sciences Core Collection, OpenGrey, ETHos and ProQuest. All databases were searched from inception to 18th October, 2024. Random-effects proportional meta-analysis was used to estimate prevalence. A narrative synthesis of the interventions from the included studies for sleep apnoea was reported.

There were 36 included studies. Pooled data from 19 studies indicated that sleep apnoea prevalence was 59% (95% CI 47%, 70%). Pooled data estimated mild apnoea prevalence at 21% (95% CI 16%, 26%) (11 included studies), with moderate and severe prevalence being 44% (95% CI 30%, 60%) (14 included studies). The majority of sleep apnoea was obstructive (75% (95% CI 53%, 89%)) with the remaining being central (15% (95% CI 8%, 28%)) and mixed (15% (95% CI 3%, 49%)) in nature.

The prevalence of sleep apnoea is high in people receiving dialysis. Currently there is insufficient evidence for the effective treatment of sleep apnoea in this population.

The online version contains supplementary material available at 10.1007/s40620-025-02370-x.

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