Factors Associated With Poor Sleep Quality in Patients With Early-Stage Chronic Kidney Disease: A Cross-Sectional Study.

Abstract

The prevalence of poor sleep quality tends to increase progressively as renal function deteriorates. Patients with declining kidney function frequently encounter both physical and psychological discomfort. However, research investigating the factors influencing sleep quality in individuals with early-stage chronic kidney disease (CKD) has been limited. This study aims to identify specific factors associated with early-stage CKD that may contribute to poor sleep quality and to elucidate the relationship between these factors and sleep quality. A hundred and six patients completed the assessment, including the renal function test, Pittsburgh Sleep Quality Index, Beck Depression Inventory-Second Edition, and fatigue severity scale. Logistic regression analyses and partial least squares structural equation modeling were used to analyze the data. Poor sleep quality was reported in 59.43% of patients with early-stage CKD. Significant associations were found between poor sleep quality and age (p < .01; 95% confidence interval: [1.03, 1.17]), severity of depression (p = .01, [1.05, 1.48]), and severity of fatigue (p = .02, [1.09, 2.71]). By contrast, estimated glomerular filtration rate (eGFR) (p = 0.53, [0.96, 1.02]) did not demonstrate a significant association with poor sleep quality. Further analysis revealed that fatigue and depression are key contributors to poor sleep quality and may be influenced by declining renal function, even though the eGFR is not directly related to sleep outcomes. Addressing psychological factors, particularly fatigue and depression, is crucial for the improvement of sleep quality in patients with early-stage CKD. Future strategies should be focused on comprehensive care approaches that specifically target fatigue and depression to enhance sleep quality in this patient population.