Benz RL, Pressman MR, Hovick ET, Peterson DD
Anemia of chronic renal failure, sleep disorders, and
daytime alertness: benefits of normalizing hematocrit (the
SLEEPO trial)
43rd Annual ASAIO Conference, Atlanta
ASAIO J
(Apr) 43:76 1997
Sleep disorders are common among patients with end-stage renal disease. It
has been noted that 72% of CRF patients with sleep complaints have abnormal
periodic leg movements (PLMS) which cause arousal from sleep. The
investigators attempted to raise hematocrit to the normal range to correct
this marker of disordered sleep.
Ten HD patients with history of abnormal sleep, and with abnormal PLMS, were
treated with increased rHuEPO doses to increase the Hct into the normal
range. The authors do not state the period of time in which Hct was
maintained at normal levels. With the normal Hct, there was a marked
improvement in PLMS, accompanied by evidence of improved wakefulness during
daytime hours. Patients were subsequently returned to baseline anemia Hcts,
with a return to prior levels of abnormal PLMS and wakefulness.
Comment: These are provocative results suggesting an important
cognitive benefit of
normalizing the hematocrit. Further studies in this area should attempt to
solidify our understanding of the importance of these results. For example,
do the improvements noted in this study have any real impact on patient's
quality of life or functional status? I would guess that they would, but
further research is needed.
(Stephen Fishbane, M.D., Winthrop University Hospital, Mineola, NY)
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43rd Annual ASAIO Conference, Atlanta
CRF by problem area :
Anemia/Erythropoietin/Iron
CRF by organ system :
Neurological