Sleep disorders are highly prevalent in chronic kidney disease (CKD) but are often under-recognized. Restless legs syndrome, which is common in CKD owing to issues with dopamine metabolism and is exacerbated by iron deficiency and uraemia, can lead to poor sleep quality and increased daytime fatigue. Insomnia is also prevalent in CKD, particularly in patients requiring dialysis, with increased sleep latency and sleep fragmentation being reported. The cause of insomnia in CKD is multifactorial — poor sleep habits and frequent napping during dialysis, uraemia, medications and mood disorders have all been suggested as potential contributing factors. Sleep apnoea and CKD are also now recognized as having a bi-directional relationship. Sleep apnoea is a risk factor for accelerated progression of CKD, and fluid overload, which is associated with kidney failure, can lead to both obstructive and central sleep apnoea. The presence of obstructive sleep apnoea in CKD can exacerbate the already heightened cardiovascular morbidity and mortality in these patients, as well as leading to daytime fatigue and reduced quality of life. Increased awareness, timely diagnosis and appropriate therapeutic interventions are essential to reduce the negative impact of sleep disorders in patients with kidney disease.

睡眠障碍在慢性肾脏病 (CKD) 中非常普遍，但常常未被充分认识。由于多巴胺代谢问题，不宁腿综合症在慢性肾病中很常见，缺铁和尿毒症会加剧这种综合症，可导致睡眠质量差和白天疲劳增加。失眠在 CKD 中也很常见，特别是在需要透析的患者中，据报道睡眠潜伏期增加和睡眠碎片化。慢性肾病患者失眠的原因是多因素的——不良的睡眠习惯和透析期间频繁小睡、尿毒症、药物和情绪障碍都被认为是潜在的促成因素。睡眠呼吸暂停和慢性肾病现在也被认为具有双向关系。睡眠呼吸暂停是 CKD 加速进展的危险因素，而与肾衰竭相关的液体超负荷可导致阻塞性和中枢性睡眠呼吸暂停。 CKD 中阻塞性睡眠呼吸暂停的存在会加剧这些患者本已较高的心血管发病率和死亡率，并导致白天疲劳和生活质量下降。提高认识、及时诊断和适当的治疗干预对于减少肾病患者睡眠障碍的负面影响至关重要。