Ryohei Yamamoto1, Maki Shinzawa2, Yoshitaka Isaka2, Etsuko Yamakoshi3, Enyu Imai4, Yasuo Ohashi5, Akira Hishida6. 1. Health Care Division, Health and Counseling Center, Osaka University, Toyonaka, Osaka, Japan; yamamoto@hacc.osaka-u.ac.jp. 2. Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 3. Statcom Company Limited, Bunkyo-Ku, Tokyo, Japan. 4. Nakayamadera Imai Clinic, Takarazuka, Hyogo, Japan. 5. Chuo University Bunkyo-ku, Tokyo, Japan; and. 6. Yaizu City Hospital, Yaizu, Shizuoka, Japan.
Abstract
BACKGROUND AND OBJECTIVES: Shorter or longer sleep duration and poor sleep quality are risk factors for numerous cardio-metabolic diseases, cardiovascular disease, and mortality in subjects with normal kidney function. The association of sleep duration and sleep quality with health outcomes in patients with CKD remains uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A 4-year prospective cohort study in 17 nephrology centers in Japan, the CKD Japan Cohort (CKD-JAC) Study, assessed an association of self-reported sleep duration and sleep quality, on the basis of the Pittsburgh Sleep Quality Index (PSQI) questionnaire, with incidence of ESKD in 1601 patients with eGFR 10-59 ml/min per 1.73 m2 using multivariable-adjusted Cox proportional hazards models. RESULTS: Baseline sleep duration and PSQI global score for the 1601 patients were mean±SD 7.0±1.3 hours and median 4 (interquartile range, 3-7), respectively. Poor sleep quality (PSQI global score ≥6) was common (n=588 [37%]). During a median of 4.0 (2.6-4.3) years of the follow-up period, 282 (18%) patients progressed to ESKD. After adjusting for age, sex, eGFR, urinary albumin excretion, smoking status, body mass index, history of diabetes and cardiovascular disease, systolic BP, blockade of the renin-angiotensin system, use of hypnotics, and Beck depression inventory score, both shorter (≤5 hour) and longer (>8 hour) sleep duration were associated with ESKD (adjusted hazard ratios [95% confidence intervals] for ≤5.0, 5.1-6.0, 6.1-7.0, 7.1-8.0, and ≥8.0 hours were 2.05 [1.31 to3.21], 0.98 [0.67 to 1.44], 1.00 [reference], 1.22 [0.89 to 1.66], and 1.48 [1.01 to 2.16]), suggesting a U-shaped relationship between sleep duration and ESKD. PSQI global score ≥6 was also associated with incidence of ESKD (adjusted hazard ratios [95% confidence intervals] for PSQI global score ≤5 and ≥6 were 1.00 [reference] and 1.33 [1.03 to 1.71]). CONCLUSIONS: Shorter (≤5 hour) and longer (>8 hour) sleep duration and poor sleep quality (PSQI global score ≥6) were associated with ESKD in patients with CKD.
BACKGROUND AND OBJECTIVES: Shorter or longer sleep duration and poor sleep quality are risk factors for numerous cardio-metabolic diseases, cardiovascular disease, and mortality in subjects with normal kidney function. The association of sleep duration and sleep quality with health outcomes in patients with CKD remains uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A 4-year prospective cohort study in 17 nephrology centers in Japan, the CKD Japan Cohort (CKD-JAC) Study, assessed an association of self-reported sleep duration and sleep quality, on the basis of the Pittsburgh Sleep Quality Index (PSQI) questionnaire, with incidence of ESKD in 1601 patients with eGFR 10-59 ml/min per 1.73 m2 using multivariable-adjusted Cox proportional hazards models. RESULTS: Baseline sleep duration and PSQI global score for the 1601 patients were mean±SD 7.0±1.3 hours and median 4 (interquartile range, 3-7), respectively. Poor sleep quality (PSQI global score ≥6) was common (n=588 [37%]). During a median of 4.0 (2.6-4.3) years of the follow-up period, 282 (18%) patients progressed to ESKD. After adjusting for age, sex, eGFR, urinary albumin excretion, smoking status, body mass index, history of diabetes and cardiovascular disease, systolic BP, blockade of the renin-angiotensin system, use of hypnotics, and Beck depression inventory score, both shorter (≤5 hour) and longer (>8 hour) sleep duration were associated with ESKD (adjusted hazard ratios [95% confidence intervals] for ≤5.0, 5.1-6.0, 6.1-7.0, 7.1-8.0, and ≥8.0 hours were 2.05 [1.31 to3.21], 0.98 [0.67 to 1.44], 1.00 [reference], 1.22 [0.89 to 1.66], and 1.48 [1.01 to 2.16]), suggesting a U-shaped relationship between sleep duration and ESKD. PSQI global score ≥6 was also associated with incidence of ESKD (adjusted hazard ratios [95% confidence intervals] for PSQI global score ≤5 and ≥6 were 1.00 [reference] and 1.33 [1.03 to 1.71]). CONCLUSIONS: Shorter (≤5 hour) and longer (>8 hour) sleep duration and poor sleep quality (PSQI global score ≥6) were associated with ESKD in patients with CKD.
Authors: S Susan Hedayati; Abu T Minhajuddin; Robert D Toto; David W Morris; A John Rush Journal: Am J Kidney Dis Date: 2009-06-03 Impact factor: 8.860
Authors: Stacey J Elder; Ronald L Pisoni; Tadao Akizawa; Rachel Fissell; Vittorio E Andreucci; Shunichi Fukuhara; Kiyoshi Kurokawa; Hugh C Rayner; Anna L Furniss; Friedrich K Port; Rajiv Saran Journal: Nephrol Dial Transplant Date: 2007-10-01 Impact factor: 5.992
Authors: Oreste Marrone; Fabio Cibella; Gabriel Roisman; Pawel Sliwinski; Pavol Joppa; Ozen K Basoglu; Izolde Bouloukaki; Sophia Schiza; Athanasia Pataka; Richard Staats; Johan Verbraecken; Jan Hedner; Ludger Grote; Maria R Bonsignore Journal: J Clin Sleep Med Date: 2020-09-15 Impact factor: 4.062
Authors: Cihan Heybeli; Pinar Soysal; Mehmet Asi Oktan; Lee Smith; Ali Çelik; Rumeyza Kazancioglu Journal: Aging Clin Exp Res Date: 2021-08-27 Impact factor: 3.636
Authors: Jeremy Pomeroy; Jeffrey J VanWormer; Jill R Meilahn; Tara Maki; Hema R Murali; Robert M Haws Journal: Orphanet J Rare Dis Date: 2021-06-14 Impact factor: 4.123