Factors associated with poor sleep quality in patients with pre‐dialysis chronic kidney disease: A systematic review

Abstract

Aims: To determine factors associated with poor sleep quality among patients with pre-dialysis chronic kidney disease. Design: This is a systematic review study guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements and checklist. Data Sources: Empirical evidence was sought in major electronic databases, including Embase, MEDLINE, CINAHL and Airiti library from March to September 2022. Review Methods: Studies investigating factors associated with poor sleep quality among adult patients with chronic kidney disease were included. Study participants who received renal replacement therapy and had sleep disorders and serious illnesses such as cancer were excluded. Of the 526 studies that resulted from the search after removing duplicate articles, 20 studies were assessed for quality by using Joanna Briggs Institute and Newcastle-Ottawa Scale by two doctorial prepared nursing scientists.Results: A total of 20 studies were included in this review. The prevalence of poor sleep quality in these studies ranged from 11% to 97.5%. Demographics (older age and female), physiological conditions (higher body mass index, higher hip circumferences, higher systolic blood pressure, poor cardiovascular function, dyspnoea, pain, cramps, itchiness or moderate to extreme pruritus, lower fasting plasma glucose, electrolyte imbalance, higher total cholesterol and gastrointestinal symptoms), depression, smoking, arousal-related and cognitive arousal behaviours were associated with poor sleep quality. Conclusion: Poor sleep quality was prevalent and influenced kidney function, increased mortality as well as decreased quality of life in patients with pre-dialysis chronic kidney disease. This review synthesizes factors associated with poor sleep quality. Managing these factors can mitigate and prevent poor sleep quality. Impact: Healthcare providers, especially nurses, can assess the risk factors of poor sleep quality and reinforce patients' self-management. Future research should elucidate the assessment and management of risk factors and transfer these into widespread use in the routine care of patients with chronic kidney disease.

Sleep quality and associated factors among patients with chronic kidney disease in Nigeria: a cross-sectional study

“…There was a significant association between poor sleep quality, anxiety and depressive symptoms. This is similar to findings from some previous studies 12 27 38–42. Those with anxiety were twice more likely to have poor sleep quality compared with those without anxiety.…”

“…14 29 Pruritus was found to be significantly associated with poor sleep quality. This is corroborated by the report of systematic review by Huang et al 42 that showed that pruritus is one of the significant factors associated with poor sleep quality among patients with CKD. This finding is not surprising because Open access pruritus-induced scratching may cause sleep interruption and poor sleep quality.…”

“…This finding is not surprising because Open access pruritus-induced scratching may cause sleep interruption and poor sleep quality. The systematic review by Huang et al 42 also reported an association between sleep quality in patients with CKD, gastrointestinal symptoms, anthropometric indices, cardiovascular risk factors such as blood pressure, dyslipidaemia which were not considered in this study.…”

Sleep Quality and Its Affecting Factors among Hemodialysis Patients: A Multicenter Cross-Sectional Study

“…Recent studies have also pointed out that the quality of sleep for patients who undergo regular HD is affected by many factors. A recent systematic review reported that demographics (older age and female), electrolyte imbalance, pain, and itching were associated with poor sleep quality [ 21 ]. In Turkey, poor sleep quality was observed among older patients who were unemployed and were on regular HD [ 22 ].…”

Plain Water Intake, Sleep Quality, and Hydration Status of Pregnant Woman in Hainan, China: A Cross-Sectional Study

“…Sleep may influence the amount of water discharged by affecting these factors, thereby impacting hydration status in women during pregnancy. A key physiological pathway connecting hydration and sleep is the circadian release of antidiuretic hormone or vasopressin [ 33 , 34 ]. Vasopressin release increases later in sleep, helping to regulate hydration during sleep.…”