Sleep disturbances in adults with chronic kidney disease: an umbrella review.

Abstract

Background: This umbrella review aimed to synthesise the existing evidence on sleep disturbances and sleep disorders in the adult chronic kidney disease (CKD) population.

Methods: A systematic search across five electronic databases. Reviews were grouped according to aspects of sleep and the focus of the review. The JBI critical appraisal checklist was used for quality assessment, and Preferred Reporting Items for Overviews of Reviews (PRIOR) guideline was used for reporting. The protocol was registered in the international registry PROSPERO (CRD42024527039).

Results: We identified 50 reviews covering three main aspects of sleep (sleep apnoea, restless legs syndrome and other sleep disturbances) across five focus areas (prevalence, interventions, health outcomes, determinants of sleep and patient experience). Most reviews reported on sleep disturbances (72%, 36 reviews) and focused on interventions (58%, 29 reviews). In contrast, evidence on sleep determinants and patient experience was limited. A high prevalence of sleep apnoea (49%), restless legs syndrome (27.2%) and other sleep disturbances (55%) was reported. Non-pharmacological interventions, including aromatherapy, dialysis, muscle relaxation, yoga, music, and nurse-led management, were found to improve sleep. However, this evidence was based on a single meta-analysis with few primary studies.

Conclusions: Despite the growing number of reviews on interventions to improve sleep, the evidence for their effectiveness is limited by the small number of primary studies and the high degree of overlap between reviews. Further research is needed to identify effective interventions. Additionally, qualitative studies exploring patients' perspectives on sleep are essential, as evidence in this area remains scarce.