Anemia, fluid overload, uremic toxin buildup, metabolic problems, and disturbed circadian rhythms all contribute to poor sleep quality when renal function deteriorates. Renal patients frequently have insomnia, obstructive sleep apnea, periodic limb movement disorder, restless legs syndrome, and excessive daytime drowsiness. Normal sleep patterns are further disturbed by dialysis-related variables, such as treatment mode and time.
Since sleep disruptions are linked to worse quality of life, cognitive impairment, elevated cardiovascular risk, and increased mortality, they are clinically significant in this population. Improving overall outcomes for individuals with renal disease requires early detection and focused treatment. This study investigated the relationship between sleep problems in matched groups of dialysis patients with ESRD and patients who have received kidney transplants.
Patients receiving dialysis for end-stage renal disease (ESRD) and post-organ transplant recipients participated in this clinic-based cross-sectional research. The Epworth Sleepiness Scale (ESS), Berlin Questionnaire (BQ), Pittsburgh Sleep Quality Index (PSQI), STOP-BANG questionnaire, and questionnaires for insomnia and restless legs syndrome (RLS) were among the structured sleep questionnaires used in the study in addition to collecting demographic data.
A total of 386 participants were examined in the study, including 159 (41.2%) individuals who had received kidney transplants and 227 (58.8%) ESRD patients receiving dialysis. The unmatched analysis's findings showed that, in comparison to ESRD patients on dialysis, kidney transplant recipients had much reduced risks of sleep problems.
Renal transplantation is still significantly linked to lower odds of sleep disorders after matching: insomnia (OR = 0.083, 95% CI: 0.030–0.231), EDS (OR = 0.034, 95% CI: 0.005–0.253), RLS (OR = 0.229, 95% CI: 0.106–0.493), poor sleep quality (OR = 0.265, 95% CI: 0.127–0.552), high risk for obstructive sleep apnoea (OSA) using BQ (OR = 0.217, 95), and high risk for OSA using STOP-BANG criteria (OR = 0.122, 95).
The length of time after transplant did not significantly affect sleep disturbances. In addition to highlighting the advantages of renal transplantation in lowering the risk of OSA, insomnia, RLS, and increasing overall sleep quality, this study validates the continued impact of end-stage renal disease on sleep disorders in patients.
Source:
Alharbi, T., Alahmadi, S., Almejaish, T., Albaroudi, A., Alsaif, M., Albadr, M., Al-Jahdali, Z., Altheaby, A., Alharbi, K., & Al-Jahdali, H. (2025). Sleep disorders in renal patients: a comparative analysis of dialysis and post-renal transplant outcomes. Scientific Reports, 1–8. https://doi.org/10.1038/s41598-025-28159-3
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