REVIEW article
Front. Med.
Sec. Nephrology
Global prevalence of poor sleep quality in hemodialysis patients: A systematic review and meta-analysis
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
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Background: Poor sleep quality is associated with various adverse outcomes among hemodialysis (HD) patients. Although poor sleep quality is a widely recognized health issue in HD patients, the reported prevalence in the current literature are remarkably inconsistent. This study aimed to determine the global prevalence of poor sleep quality in HD patients. Methods: A comprehensive literature search was conducted across seven electronic databases (PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, PsycINFO) from their inception to October 20, 2025. Data extraction was performed using a standardized form, and the methodological quality of included studies was evaluated with the Joanna Briggs Institute (JBI) critical appraisal checklist for prevalence studies. A random-effects model was applied to calculate the pooled prevalence of poor sleep quality, and the heterogeneity was quantified using the I² statistic. Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity. Results: A total of 69 studies involving 14998 HD patients were included in the meta-analysis. The pooled global prevalence of poor sleep quality was 64.2% (95% CI: 60.5-67.8%). Based on the JBI critical appraisal tool, 55 studies were rated as having a low risk of bias, while 14 were considered to have a moderate risk of bias. Subgroup analysis revealed that the pooled prevalence varied significantly by the cut-off values. Meta-regression results indicated that prevalence was not significantly associated with sample size, mean age, dialysis duration, and proportion of females. Conclusions: Our findings demonstrate a high prevalence of poor sleep quality among HD patients. To mitigate the adverse effects of poor sleep quality on HD patients, healthcare providers should routinely conduct screenings and deliver evidence-based interventions.
Keywords: Epidemiology, hemodialysis, Meta-analysis, Poor sleep quality, Prevalence
Received: 18 Dec 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Shi, Zhou, Chen, Zhang, Yu, Zhang, He and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Guifen Shi
Lin Chen
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