Sleep Hygiene Among People With CKD

Abstract

Good sleep hygiene is recommended for individuals with chronic kidney disease (CKD). However, limited research has explored sleep hygiene in this population. This study aimed to examine sleep hygiene in individuals with CKD and explore its relationship with sleep outcomes and fatigue. A cross-sectional survey in 4 nephrology units across 3 Australian states to assess sleep hygiene (sleep hygiene index[SHI]), sleep outcomes (Pittsburgh sleep quality index[PSQI]), and fatigue (functional assessment of chronic illness therapy - fatigue[FACIT-F]). Linear regression models were constructed to identify the relationships between sleep hygiene, fatigue, and sleep outcomes. Of the 231 survey participants, the mean age was 63 ± 16 years, 67% were male, and 62% received hemodialysis. Overall, sleep hygiene was good (mean SHI: 13.7 ± 7.7); however, sleep outcomes were poor (mean PSQI: 9.1 ± 4.5), and fatigue was high (mean FACIT-F: 27.1 ± 10.0). Only 17% were aware of sleep hygiene. Frequent poor sleep hygiene included daytime napping, irregular bed and wake times, and worry when in bed. Poor sleep hygiene scores were independently associated with greater fatigue (coefficient [β]: -0.54, 95% confidence interval [CI]: -0.70 to -0.38) and with poorer sleep outcomes (coefficient[β]: 0.16, 95% CI: 0.08-0.25). Sleep hygiene was associated with fatigue and sleep outcomes; however, despite generally good sleep hygiene practices, poor sleep and high fatigue remained common in individuals with CKD. This suggests that sleep hygiene alone is insufficient and should form only 1 component of a broader, multifaceted approach to improving sleep and fatigue in this population.