Sleep complaints and sleep disordered breathing in hemodialysis patients.

BACKGROUND: The objective of the study was to determine the prevalence of sleep complaints and of sleep disordered breathing (SDB) in hemodialysis patients not selected for sleep complaints and to determine the effect of hemodialysis on SDB. The feasibility of home recording of sleep related respiration in these patients was also studied. METHODS: The patients completed a questionnaire and parameters of SDB were examined in the home setting on nights following dialysis and nights following no dialysis with the Edentrace II Recording System. RESULTS: Six (46%) of 13 patients had sleep complaints. Symptoms suggestive for sleep apnea syndrome were found in four (31%) of these 13 patients. In three (75%) of these four patients SDB was found. Sleep related respiration was monitored in 15 patients. Registrations satisfactory for interpretation were obtained in all patients. SDB was observed in five (33%) of these 15 patients. There were no significant differences in parameters of SDB between nights following dialysis and nights following no dialysis. CONCLUSIONS: Home recording of sleep related respiration in hemodialysis patients is feasible. Sleep complaints and SDB are common in these patients. No clinically significant differences in SDB were found between nights following dialysis and nights following no dialysis.

Extracorporeal magnetic innervation therapy: assessment of clinical efficacy in relation to urodynamic parameters.

OBJECTIVE: Clinical efficacy and urodynamic changes in women treated by extracorporeal magnetic innervation therapy (ExMI) were studied. MATERIAL AND METHODS: Women, presenting with urge, stress and mixed urinary incontinence, were included in a prospective study. ExMI was applied by an electromagnetic chair. To document clinical efficacy, a voiding diary and visual analogue scale were completed before and after treatment, together with a pad test. Detrusor overactivity (DO) and urethral instability (URI) were urodynamically documented. Clinical success was defined as more than 50% improvement in symptoms. RESULTS: Sixteen patients were included. At baseline, DO was observed in 10 patients, and URI in 12 patients. DO did disappear at follow-up in 60%, and a decrease in URI was seen in 66%. No significant clinical improvement was seen at follow-up. CONCLUSION: Although significant changes in urodynamic variables were observed, no significant improvement in clinical efficacy was seen after ExMI.

Functional extracorporeal magnetic stimulation as a treatment for female urinary incontinence: 'the chair'.

OBJECTIVE: To evaluate, in a prospective study, the efficiency and applicability of functional magnetic stimulation (FMS) of the pelvic floor for treating urinary incontinence in women. PATIENTS AND METHODS: FMS was provided by a 'magnetic chair'; 24 patients were treated twice weekly for 8 weeks (12 with urge incontinence and 12 with a mixture of urge and stress incontinence). The outcome was assessed urodynamically, by a pad test, and by patient satisfaction. RESULTS: In 58% of the patients there was an objective improvement in incontinence; three patients were completely dry and 71% reported a subjective improvement (P < 0.001). CONCLUSION: FMS is a safe, noninvasive and painless treatment for urinary incontinence; it is effective and easy to administer as an outpatient treatment.