Sleep disturbances are common among adults with chronic kidney disease (CKD) stage 4–5, including those receiving kidney replacement therapy. In this multicenter Australian cohort, 234 participants completed the survey and 73% were classified as poor sleepers. The most frequently reported contributors to disturbed sleep were fragmented sleep (56%), nocturia (44%), and restless legs syndrome (27%). These factors reflect both sleep architecture disruption and CKD-related symptoms that interfere with sleep continuity.
The study population was predominately male (67%), aged over 60 years, and 62% were receiving hemodialysis. These demographic and treatment characteristics contextualize the observed high prevalence of poor sleep but subgroup-specific prevalence details beyond these aggregate figures were not provided in the abstract.
When asked to rank outcomes, participants prioritized subjective restorative elements of sleep above other downstream impacts. Specifically, feeling refreshed on waking and satisfaction with sleep were rated as the highest-priority outcomes. These patient-centered priorities were placed above measures such as social participation, ability to work, and hospital admissions, indicating that patients value immediate, experiential aspects of sleep quality.
This emphasis on restorative and satisfaction measures suggests that interventions and outcome measurement in CKD-related sleep research and clinical care should incorporate patient-reported metrics of morning refreshment and overall sleep satisfaction alongside conventional sleep measures.
Sleep problems were frequently under-recognised in routine care. Overall, 41% of survey respondents reported that their treating clinical team had never asked them about sleep. Among participants who did raise sleep concerns with clinicians, nearly one-quarter reported receiving no management in response.
These findings indicate gaps in clinician inquiry and follow-up for sleep issues in CKD, contributing to unmet needs. The study abstract does not provide detail on reasons clinicians did not ask about sleep or on barriers to offering management when concerns were raised.
Reported management for sleep problems was inconsistent and not well aligned with patient preferences. Pharmacological therapy was the most commonly reported clinical management strategy, used by 33% of participants who received management. Despite the predominance of medication-based approaches, participants expressed a preference for nonpharmacological strategies.
The abstract does not enumerate which specific pharmacological agents or nonpharmacological interventions were used or preferred, nor does it report effectiveness or adverse effects. It does, however, highlight a mismatch between what is offered in clinical practice and what patients would prefer, suggesting a need to broaden access to and availability of nonpharmacological options in nephrology services.
Use of consumer sleep-monitoring technology was low in this cohort: 9% of participants reported using a wearable sleep tracker at the time of the survey. However, interest in such technology was notable, with a further 41% stating they would be willing to try a wearable tracker.
The authors propose that greater access to wearable technologies may support monitoring and patient engagement. The abstract does not provide detail on the types of devices used, how tracker data were interpreted or integrated into care, or whether wearables affected management decisions.
This research employed a convergent mixed-methods design conducted across four nephrology units in three Australian states. Survey data were collected from 234 adults with CKD stage 4–5, and in-depth interviews were conducted with 14 participants. Quantitative survey findings were analyzed using descriptive statistics and subgroup comparisons; qualitative interview data were subjected to thematic analysis. The quantitative and qualitative strands were integrated using triangulation to synthesize findings.
The abstract supplies these high-level design and analytic details but does not report full quantitative tables, statistical comparisons by subgroup, or the specific themes and illustrative quotations from interviews.
In this multicenter cohort of people with advanced CKD, sleep disturbances were common, under-recognised, and inconsistently managed. Clinical practice relied frequently on pharmacological approaches, while patients expressed a preference for nonpharmacological strategies. Relatively low current use but substantial willingness to adopt wearable sleep trackers suggests potential for technology to aid monitoring and engagement.
Taken together, these findings imply a need for more routine screening for sleep issues in nephrology settings, better alignment of management with patient preferences (including expanded availability of nonpharmacological interventions), and exploration of how wearable technologies could be integrated into care pathways.
Limitations and missing details: the abstract does not report specific nonpharmacological interventions evaluated or offered, the content of subgroup comparisons, interview quotations, or the effectiveness and safety outcomes of reported management approaches. Those details were not available in the source text provided.