Abstract: FR-PO427
High Prevalence of Sleep Pathology in Pediatric Hemodialysis Patients as Assessed by the ActiGraph® Accelerometer
Session Information
- Pediatric Nephrology - I
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Chawla, Jonathan Sterling, Baylor College of Medicine, Houston, Texas, United States
- Vega, Molly Rw, Texas Children's Hospital, Houston, Texas, United States
- Shah, Shweta S., Baylor College of Medicine, Houston, Texas, United States
- Kaplan, Kevin, Baylor College of Medicine, Houston, Texas, United States
- Geer, Jessica, Texas Children's Hospital, Houston, Texas, United States
- Zimmerman, Cortney Taylor, Baylor College of Medicine, Houston, Texas, United States
- Akcan Arikan, Ayse, Baylor College of Medicine, Houston, Texas, United States
- Swartz, Sarah J., Baylor College of Medicine, Houston, Texas, United States
- Srivaths, Poyyapakkam, Baylor College of Medicine, Houston, Texas, United States
Background
Adults with end-stage kidney disease (ESKD) have a higher prevalence of sleep disturbances, which is associated with higher rates of depression and worse quality of life. Poor sleep quality is underdiagnosed in pediatric (ped) ESKD. ActiGraph accelerometers (ACG) are validated assessors of ped sleep quality. We hypothesized ACG is more sensitive than sleep questionnaire in detecting poor sleep quality in ped HD pts.
Methods
In this prospective cohort study, pts 8-18 years on HD for >3 months wore an ACG on their non-dominant wrist for one week. They were asked to log sleep/wake times daily. Pts/parents completed the Sleep Disturbance Scale for Children (SDSC) and a restless leg syndrome (RLS) screening. Sleep time <7hrs, ACG sleep efficiency <85% and SDSC Total T-scores >55 considered significant sleep impairment as per pervious published standards.
Results
14 pts completed ACG: 64% male, mean age 15.6 ±2.5yr, mean HD vintage 1 ±0.9yr, mean BMI Z-score -0.42 ±1.5. All pts had three 240min treatments per week. ACG showed 50% pts had sleep duration <7hrs, and 85.7% had impaired sleep efficiency, while SDSC showed only 71.4% pts had poor sleep. There was a poor correlation between SDSC total score, RLS score, and ACG sleep efficiency (Pearson’s R). ACG-detected total sleep time had positive correlation with sleep efficiency (R=0.64, p=0.01) and number of awakenings (R=0.59, p=0.03), though those awakenings were shorter (R=-0.64, p=0.01). Age, vintage or CKD labs were not associated with sleep efficiencies. Pts with <7hrs of sleep tended to have lower sleep efficiency (mean 65.9% ±14.4%) compared with >7hrs (mean 77.4% ±5.6%; p=0.07).
Conclusion
In this first study using ACG in ped HD pts, there was high prevalence of sleep disturbances with half getting <7hrs sleep and high prevalence of poor efficiency in all. ACG provided objective measures of sleep disturbance, superior to sleep questionnaire. Further studies are needed to assess the impact of poor sleep on quality of life and CV morbidity in ped HD pts.