This study aimed to assess sleep quality in patients with chronic kidney disease (CKD) in the Aseer Region of Saudi Arabia. This cross-sectional study focused on non-dialysis patients who attended CKD clinics. We used the validated Arabic version of the Pittsburgh Sleep Quality Index scoring questionnaire, which involves 7 component scores, each rated on a scale of 0 to 3. These component scores were aggregated to calculate a global score that ranged from 0 to 21. A global score >5 indicated poor sleep quality. The mean participants' age was 53.8 ± 17.9 years, 66.5% were male, 93.5% were Saudi, 75.0% resided in high-altitude areas, 69.0% were married, 46% had an education level below the secondary level, 33.0% were employed, and 52.5% had a monthly income of <5000 Saudi Riyal. Regarding body mass index, 52.5% were overweight and 26% were obese. The global Pittsburgh Sleep Quality Index score among the study cases ranged from 1 to 17, with a mean score of 6.9 ± 3.3. In total, 123 (61.5%) were classified as poor sleepers and 77 (38.5%) as good sleepers. Predictors of poor sleep quality were age (adjusted odds ratio [AOR]: 1.40, P = .021), hypertension (AOR: 1.80, P = .046), diabetes mellitus (AOR: 1.64, P = .049), and estimated glomerular filtration rate (AOR: 0.78, P = .039). Most patients with CKD in our study experienced poor sleep quality. Factors such as age, history of comorbidities, and advanced CKD stages were associated with a higher likelihood of being a poor sleeper. Therefore, early screening and intervention for at-risk patients may be crucial for enhancing sleep quality among patients with CKD.