Abstract
ObjectivesUnhealthy sleep behaviors may be potential risk factors for chronic kidney disease (CKD). We aimed to examine the associations of combined sleep patterns and genetic susceptibility with incident CKD.MethodsThis large-scale prospective cohort study included 370,671 participants without CKD at baseline (2006–2010) in UK Biobank data. Five sleep behaviors were made up of sleep duration, insomnia, snoring, chronotype, and daytime sleepiness according to questionnaire. Overall sleep patterns by summing the five scores were created. Weighted genetic risk score of kidney function was calculated. Incident CKD was recorded from death register, primary care, and hospital inpatient records. A subset of 41,130 individuals who participated both the initial assessment visit and follow-up visit (2012+) was also used.ResultsDuring a median follow-up of 10.6 years (about 3.9 million person-years), we documented 6,365 patients with incident CKD. In five sleep behaviors, sleep 7–8 h/day, free of insomnia and no frequent daytime sleepiness were independently associated with incident CKD, with a 12% (95%CI 7–16), 9% (3–14), 13% (9–18) lower risk, respectively. Compared to those with a sleep score of 0–1, participants with a score of 5 had a 21% (10–31%) lower risk of CKD. 17.1% of CKD in this cohort could be attributed to total poor sleep pattern. Participants with high genetic risk and intermediate or poor sleep pattern showed the highest risk of CKD (OR = 2.58, 95%CI 2.24–2.96; OR = 2.59, 95%CI 2.02–3.32, respectively), although there was no significant interaction between sleep patterns and genetic risk categories. Among individuals who participated both the initial assessment visit and follow-up visit, we found that the association between amelioration of sleep pattern and risk of CKD was significant after fully adjustment (OR = 0.60, 95%CI 0.36–0.99), compared with group of stable sleep pattern.ConclusionIn this large prospective study, participants with a healthy sleep pattern was associated with a significant reduction of incident CKD risk no matter they had a high, intermediate, or low genetic risk.
Highlights
MATERIALS AND METHODSChronic kidney disease (CKD) has been becoming a critical public health burden worldwide, affecting about 10–15% of the world’s adult population and its prevalence is expected to rise further in the near future (Hill et al, 2016; Collaboration GBDCKD, 2020)
In demographic factors-adjusted model, short (8 h) sleep duration, insomnia, snoring and excessive daytime sleepiness were each associated with an increased risk of incident of CKD
After fully adjusted for smoking, drinking, physical activity, overweight and obesity, systolic blood pressure, diabetes, use of blood pressure-lowering medications and use of diabetes medications, these associated remained significant except short sleep duration, insomnia and snoring
Summary
MATERIALS AND METHODSChronic kidney disease (CKD) has been becoming a critical public health burden worldwide, affecting about 10–15% of the world’s adult population and its prevalence is expected to rise further in the near future (Hill et al, 2016; Collaboration GBDCKD, 2020). As suggested in previous studies, sleep behaviors such as sleep duration, chronotype, insomnia, snoring and excessive daytime sleepiness are usually correlated and may impact human health and life quality in a joint manner (Fan et al, 2020). It seems only one cross-sectional study combined four sleep behaviors and indicated that worse overall sleep quality was not significantly associated with higher odds of CKD (Li et al, 2017). Due to partially controversial results, limited sleep behaviors, and no prospective cohort combining sleep behaviors, the available evidence is rather limited
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