Sleep and the Risk of Chronic Kidney Disease: A Cohort Study.

Abstract

Little information is available regarding the effect of sleep on the development of chronic kidney disease (CKD). This large-cohort study aimed to investigate the association between sleep and the incidence of CKD. We recruited 194,039 participants without CKD aged 20 years or older between 1996 and 2014. Incident CKD was defined as an estimated glomerular filtration rate of < 60 mL/min/1.73 m2. Information about sleep duration and quality was obtained from a questionnaire and used to generate a score reflecting the sleep profile. Cox proportional hazards regression models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for CKD associations with sleep duration, quality, and score categories. Regarding sleep duration, participants who slept for fewer than 4 hours (HR 1.45, 95% CI 1.22-1.71), 4 to 6 hours (1.07, 1.02-1.14), or more than 8 hours (1.12, 1.04-1.21) had an increased risk of incident CKD, compared to those who slept 6 to 8 hours. Regarding sleep quality, participants who fell asleep but awoke easily (1.13, 1.07-1.19), had difficulty falling asleep (1.14, 1.06-1.22), or used sleeping pills or sedatives (1.14, 1.20-1.66) had a higher risk of incident CKD, compared to those who slept well. Furthermore, participants with sleep scores of 4 to 6 (1.07, 1.02-1.13) and less than 4 (1.61, 1.37-1.89) had an increased risk of incident CKD, compared to those with a sleep score higher than 6. A poor sleep profile is associated with increased risk of CKD development. Therefore, sleep duration and quality should be considered when developing strategies to improve sleep and thus prevent CKD. A commentary on this article appears in this issue on page 371.