Sleep and emotional disturbance in patients with non-dialysis chronic kidney disease

Sleep disorder and depression are prevalent in patients on dialysis but less investigated in earlier-stage chronic kidney disease (CKD) patients. We aimed to evaluate the prevalence of depression, anxiety, health anxiety, and sleep disturbance and explore the association between CKD stage, psychological symptoms and sleep quality.

We recruited 326 patients with CKD (stage 1-5) not on dialysis from the nephrology clinic. All participants completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Health Anxiety Questionnaire (HAQ), and Pittsburgh Sleep Quality Index (PSQI). Chi-square tests were used to assess the difference in psychological symptoms between CKD stages. Multiple linear regression was employed to assess relationships among selected variables and sleep/emotional disturbance.

Clinically significant depression, anxiety, health anxiety, and sleep disturbance were found in 3.1%, 3.1%, 18%, and 36.2% of the patients, respectively. BDI-II, BAI, HAQ, and PSQI scores did not significantly differ across CKD stages. In a multiple linear regression model that included psychological variables, BDI-II score had a statistically significant association with PSQI score (β = 0.418, p < 0.001).

Depressive symptoms were associated with sleep quality of patients with earlier-stage CKD. However, there was no significant association between CKD stage and sleep disturbance or other psychological symptoms.