Background: Fatigue and poor sleep quality are more common in children undergoing 
hemodialysis (HD) than in other healthy children. The management of fatigue and sleep disorders 
using chemical drugs is mainly costly and associated with medication's side effects, it is necessary to 
seek out appropriate complementary alternative treatments such as progressive muscle relaxation
(PMR). Objective:To investigate the effect of progressive muscle relaxation on fatigue and sleep 
quality in children undergoing hemodialysis. Setting: The study was carried out at Smouha Children's 
University Hospital (SCUH) in Alexandria, Egypt. Subjects: A convenient sample of 30 children 
having an end-stage renal disease (ESRD) undergoing HD who fulfill the following criteria was 
included: their age ranged from7-15 years old, undergoing HD for at least six months and free from 
other diseases such as neurological diseases, cerebrovascular accident or mental illness. Tools: three 
tools were used:“socio-demographic, physiological parameters and medical history of children 
undergoing hemodialysis structured interview schedule",“Pediatric Quality of Life Inventory 
(PedsQL) Multidimensional Fatigue Scale" and “Pittsburgh Sleep Quality Index (PSQI) Scale".
Results: the result of the current study revealed that, 46.7% of the studied children were aged from 
10-12 years.The study showed that the mean percentage score of the overall Pediatric Quality of Life 
Inventory Multidimensional Fatigue Scale was higher after the application of PMR (84.35 ± 5.80%) 
which indicate less fatigue, compared with the mean score before (65.09 ± 9.01%) and the difference 
between before and after was statistically significant (p= <0.001*). Moreover, the mean percentage 
score of the overall Pittsburgh Sleep Quality Index Scale was lower after application of PMR (14.60 ± 
6.49%) which indicate better sleep quality, compared with 30.63 ± 9.98% before application of this 
technique and the difference between before and after was statistically significant (p= <0.001*). 
Conclusion: progressive muscle relaxation has significantly decrease fatigue and improve sleep 
quality among children undergoing hemodialysis. Recommendations: Establishment of hospital 
administration policies and protocol for non-pharmacological management particularly PMR are 
recommended to reduce fatigue and improve sleep quality.