Poor Sleep Quality and Stress Levels Among Dialysis Patients: A Cross-Sectional Study in Kerala, India

Background Chronic kidney disease is projected to become the fifth leading cause of premature mortality worldwide by 2040. We assessed sleep quality, perceived stress, health behaviours, and associated factors among patients undergoing dialysis in Kerala, India. Methodology We analyzed data from 150 patients undergoing dialysis in Pathanamthitta district, Kerala, India. Information on health behaviors, including diet, activities of daily living, sleep, perceived stress, and medication adherence, was collected using a structured questionnaire. Sleep quality and perceived stress were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the 10-item Perceived Stress Scale (PSS-10), respectively. Descriptive and bivariate analyses were performed. Results Poor sleep quality was the most frequently reported health-related problem affecting 84.1% of participants (95% CI:76.7-89.8), followed by moderate perceived stress (60.4%, 95% CI:51.9-68.4), high perceived stress (13.2%, 95% CI:8.1-19.8), ever tobacco use (54.0%, 95% CI:45.6-62.1), and ever use of alcohol (52.7%, 95% CI:44.4-60.8). Self-reported interdialytic weight gain (IDWG) was reported by 47.9% of participants, while 90.0% reported following a fluid-restricted diet. Hypertension (83.9%) and diabetes mellitus (63.5%) were the most prevalent comorbidities. Most participants (79.3%) reported always taking their medications as prescribed. Poor sleep quality was significantly associated with perceived stress and IDWG, whereas physical limitations were significantly associated with moderate-to-high perceived stress. Conclusion Poor sleep quality was highly prevalent among patients undergoing dialysis despite generally good medication adherence. Integrating routine assessment of sleep, perceived stress, and lifestyle behaviours into dialysis care may help identify patients requiring targeted interventions to improve health outcomes and quality of life.