#1538 Sleep habits, sleep quality, and fatigue among people with chronic kidney disease

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Abstract Background and Aims Healthy sleep habits are highly recommended for individuals with chronic kidney disease (CKD) to improve quality of life and reduce kidney function decline. However, there is limited research on sleep habits of people with CKD and their impact on sleep quality and fatigue. This study aims to describe sleep habits among the CKD population and identify its correlation with sleep quality and fatigue. Method A cross-sectional survey was conducted in four nephrology units across three Australian states between 1 August 2024 and 31 December 2024. Data were collected from adults with CKD anonymously using both paper-based questionnaires and online surveys. Validated instruments, including the Sleep Hygiene Index (SHI), Pittsburgh Sleep Quality Index (PSQI) and FACIT-F, were used to assess self-reported sleep habits, sleep quality and fatigue, respectively. Participants were rogramo ve into (i) CKD not requiring kidney replacement therapy (KRT); (ii) receiving haemodialysis; (iii) receiving peritoneal dialysis; (iv) post kidney transplant; (v) receiving conservative management not on dialysis. Pearson correlation and Spearman's rank correlation were used to assess the relationship between sleep habits, sleep quality, and fatigue. Results A total of 173 surveys were returned, with 70% of respondents being male, a mean age of 64 years, and a predominance of individuals receiving haemodialysis (78%). Overall, sleep hygiene engagement was good (mean SHI 13.6, standard deviation (SD) 7.9); maximum obtainable 52, with a higher score indicating poorer sleep hygiene). Sleep quality was poor across all participants (median PSQI 8, interquartile (IQR) 5, 12; maximum obtainable 21, with a score of 5 or greater indicating “poor” sleep). Moderate fatigue was identified (mean FACIT-F 29.9, SD 12.8), maximum obtainable 52, with higher scores indicating a lower level of fatigue). There were a small number of responses from patients receiving conservative management (n = 3), those with CKD not requiring KRT (n = 7) and post kidney transplant (n = 6); therefore, these cohorts are not included in the subgroup comparison. Baseline characteristics are rogramo v in Table 1. Sleep hygiene engagement was similar in patients receiving haemodialysis (mean SHI 14, SD 7.4) and peritoneal dialysis (mean SHI 13.3, SD 10.1). Of all sleep hygiene behaviours, four were most commonly reported: (i) having daytime naps; (ii) different bedtime from day to day; (iii) different wake time from day to day; and (iv) thinking, planning or worrying when in bed, with over 50% of participants reporting them as occurring sometimes, frequently, or always (Fig. 1). Sleep quality was also similar among those on haemodialysis (median PSQI 8, IQR 5, 12) and peritoneal dialysis (median PSQI 9, IQR 5, 15). FACIT-F scores showed that individuals receiving haemodialysis patients reported a higher level of fatigue (mean FACIT-F 29.4, SD 12.3) compared to those on peritoneal dialysis (mean FACIT-F 32.2, SD 12.3). Correlation analysis revealed a weak but statistically significant relationship between sleep habits and sleep quality (rs = 0.36, P = <0.001) and fatigue (r = −0.31, P < 0.001). Conclusion This study highlights that overall sleep hygiene practices are good among individuals with CKD. Although correlations between sleep habits, sleep quality, and fatigue were weak, they were statistically significant, indicating that these relationships are unlikely to be random. These findings suggest that healthy sleep habits and fatigue and sleep are correlated. The four most commonly reported sleep hygiene behaviours identified in this study could serve as targets for interventions to promote sleep hygiene in CKD patients. However, this study also demonstrates that other influencing factors associated with sleep may not yet have been identified. Therefore, further research is needed to explore these factors to enhance sleep among individuals with CKD. Additionally, future studies should prioritise recruitment efforts targeting people with CKD who are not receiving dialysis to gain a more comprehensive understanding of the impact of sleep on this population.