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Volume 15 No. 03
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Accepted Papers





Scientific Investigations

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

Yacong Bo, MSc1; Eng-kiong Yeoh, MBBS1; Cui Guo, MSc1; Zilong Zhang, PhD1; Tony Tam, PhD2; Ta-Chien Chan, PhD3,4; Ly-yun Chang, PhD5,6; Xiang Qian Lao, PhD1,7
1Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong; 2Department of Sociology, the Chinese University of Hong Kong, Hong Kong; 3Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan; 4Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 5MJ Health Research Foundation, MJ Group, Taiwan; 6Institute of Sociology, Academia Sinica, Taiwan; 7Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China

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.

Citation:

Bo Y, Yeoh EK, Guo C, Zhang Z, Tam T, Chan TC, Chang LY, Lao XQ. Sleep and the risk of chronic kidney disease: a cohort study. J Clin Sleep Med. 2019;15(3):393–400.


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