Document Type : Review article
Authors
1 Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.
2 Student research committee, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.
3 Assistant Professor of Surgery, Department of Surgery, School of Medicine, Emdad Trauma Hospital, Sabzevar University of Medical Sciences, Sabzevar, Iran,
4 Iranian Research Center of Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran & Professor, Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
Abstract
Background: Sleep disorders are common in patients with chronic kidney disease (CKD), with effects observable even in early stages. This study aimed to identify factors associated with poor sleep quality in early-stage CKD patients.
Materials and Methods: This systematic review synthesized evidence from seven cross-sectional and observational studies (2015–2025) on factors linked to poor sleep quality in early-stage CKD (stages 1–3). Following PRISMA guidelines and registered in PROSPERO (CRD420251233840), the review included studies using validated sleep measures. Two reviewers independently extracted data and assessed study quality via the Joanna Briggs Institute checklist.
Results: Poor sleep in early-stage CKD is influenced by a complex interplay of demographic, clinical, psychological, and lifestyle factors. Older age, female sex, lower education, and living alone were significant demographic correlates. Clinically, more advanced CKD stage (lower eGFR), anemia, comorbidities (hypertension, diabetes), obesity, and longer disease duration were linked to worse sleep. Psychologically, depression was the strongest, most consistent predictor, often mediating the CKD-sleep relationship; anxiety, fatigue, and reduced quality of life also played key roles. Objective sleep measures highlighted associations with sleep-disordered breathing and periodic limb movements. Modifiable factors like physical inactivity and high-altitude residence further contributed.
Conclusion: Sleep impairment in early CKD is not merely a symptom but a multidimensional issue embedded in biopsychosocial contexts. Effective management requires integrated interventions addressing mental health, social support, and lifestyle modifications alongside standard renal care. Such a holistic strategy may improve well-being, potentially slow CKD progression, and reduce healthcare burdens.
Keywords
Main Subjects
)