Sleep and the risk of chronic kidney disease: A cohort study

Abstract

Study Objectives: 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. Methods: 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. Results: 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. Conclusions: 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. Commentary: A commentary on this article appears in this issue on page 371.