Sleep Quality, Daytime Sleepiness, and Circadian Rhythm Characteristics in Chronic Kidney Disease: A Cross-Sectional Study Across Disease Stages.

Authors

Harun Yetkin, Mehmet Fatih Uzanulu, Onur Selçuk Yiğit, Zeynep Dilara Yetkin, İrem Dikilitaş, Hacı Mehmet Çitil, Hacı Bayram Berktaş, Mehtap Karaaslan

Published in

International journal of psychiatry in medicine. Pages 912174261485675. Aug 31, 2026. Epub Aug 31, 2026.

Abstract

ObjectiveTo compare sleep quality, daytime sleepiness, and circadian rhythm characteristics across clinically defined chronic kidney disease (CKD) groups and to examine their relative contribution to global subjective sleep quality.MethodThis two-center, cross-sectional study enrolled 344 adults with CKD (response rate: 96.6%) from nephrology settings in Turkey. Participants were classified into three groups: mild-to-moderate CKD (KDIGO stages 2-3; n = 133), advanced CKD without dialysis (stages 4-5; n = 37), and dialysis-dependent CKD (stage 5D; n = 174). Sleep quality, daytime sleepiness, and circadian rhythm parameters were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Munich Chronotype Questionnaire (MCTQ). Hierarchical regression identified predictors of PSQI global scores.ResultsESS total scores were significantly higher in the dialysis-dependent group compared with both other groups (ε² = 0.182, the only large effect size), whereas PSQI global scores were paradoxically lower in this group (adjusted P = 0.021). Biological chronotype (MSFsc) did not differ across groups. In hierarchical regression, ESS (β = 0.525) and dialysis-dependent status (β = -0.318) were the only significant predictors of PSQI global scores, with sleep-wake variables adding 24.3% explained variance beyond demographic and clinical factors.ConclusionsCKD-related sleep-wake burden is more prominently reflected in daytime sleepiness and social-circadian disorganization than in global subjective sleep quality. Assessment of daytime sleepiness may improve recognition of sleep-wake dysregulation in nephrology settings.

PMID:
42673517
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.

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