Managing Sleep Disturbance among Patients on Hemodialysis: Patient and Health Care Provider Perspectives

Sleep disturbance is highly prevalent among patients on hemodialysis, severely impairing their quality of life and clinical outcomes. Sleep management in this population is particularly challenging, as it is shaped by complex interactions between patient experiences and clinical practices. The aim of this study was to explore experiences related to the management of sleep disturbance from dual perspectives from patients and healthcare providers.

This study employed a qualitative research design, using a phenomenological approach. Nineteen patients on hemodialysis and 24 healthcare providers were recruited via purposive sampling from September 2025 and January 2026. One-on-one semi-structured interviews were conducted following an interview guide. The interviews lasted around 60 minutes. Data analyses were informed by Colaizzi's method.

Four themes with 13 subthemes emerged: 1) Patients revealed their experiences of living with sleep disturbance; 2) Both patients and healthcare providers used various strategies managing sleep disturbance, in which hypnotic medication was the primary approach, while traditional Chinese medicine (e.g., Tuina) and non-pharmacological approaches served as complementary alternatives; 3) Common barriers included insufficient clinical attention, perceived inevitability, and low patient engagement, healthcare providers also revealed unique systemic barriers; 4) Enabling factors for future sleep management included shared patient-provider interest, social support for the patients, and existing hospital resources.

While a range of strategies have been tried to manage sleep disturbance among patients on hemodialysis, significant barriers persist. Nevertheless, the enabling factors offered a foundation for developing more integrated sleep management programs.