What sleep-related issue is common in CKD?

• A. Only insomnia with caffeine
• B. Sleep apnea only
• C. Narcolepsy
• D. Sleep disturbances or restless legs syndrome; can affect quality of life

Answer: (D)

In CKD, sleep problems are common and greatly impact how patients feel day-to-day. The most accurate statement recognizes that sleep disturbances, including restless legs syndrome (RLS), frequently occur and can significantly affect quality of life. RLS involves uncomfortable sensations in the legs with an urge to move, especially at rest and at night, which disrupts falling and staying asleep. In CKD, factors like iron deficiency, toxins accumulating with reduced kidney function, and changes in dopamine signaling contribute to RLS and other sleep issues. These problems often worsen around dialysis and can lead to daytime fatigue, mood changes, and poorer overall well-being. While insomnia or sleep apnea can occur, they’re not the only or defining sleep problem in CKD, and narcolepsy is not typically linked to CKD. Hence, recognizing that sleep disturbances or restless legs syndrome are common and affect quality of life best captures the issue.