U-Shaped Relationship between Sleep Duration and CKD in US Adults: Data from National Health and Nutrition Examination Survey (NHANES) 2005–2014

Introduction: Short and long sleep durations have been associated with adverse health outcomes. The objective of this study was to examine the association between self-reported sleep duration and chronic kidney disease (CKD) in the general population on the basis of the National Health and Nutrition Examination Survey (NHANES) database. Methods: A total of 28,239 adults aged ≥18 years who participated in the 2005–2014 NHANES were analyzed. CKD was defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m2 or urinary albumin/urine creatinine ratio ≥300 mg/g. Very short sleepers and short sleepers were defined as those who sleep ≤5 h or 5.1–6.9 h per day, respectively. Long sleepers and very long sleepers were defined as those who sleep 9.0–10.9 h or ≥11 h per day, respectively. Normal sleepers were defined as those who sleep 7.0–8.9 h. The association between sleep duration and CKD was assessed using a logistic regression model. Results: Very short (≤5 h) sleep duration was associated with higher odds of CKD (multiadjusted OR, 1.38; 95% confidence interval, 1.17–1.62 comparing normal categories of 7.0–8.9 h; P trend = 0.01), after adjusting for potential confounders. Participants with long (9–10.9 h) sleep duration also tended to have a higher odds of CKD (multiadjusted OR, 1.39; 95% confidence interval, 1.20–1.61 comparing normal categories of 7.0–8.9 h; P trend = 0.01). This risk was further increased in those whose sleep duration exceeded 11 h (multiadjusted OR, 2.35; 95% confidence interval, 1.64–3.37 comparing normal categories of 7.0–8.9; P trend = 0.01). However, there was no statistically significant association between short (≤6.0–7.9 h) sleep duration and CKD (multiadjusted OR, 1.05; 95% confidence interval, 0.96–1.14 comparing normal categories of 7.0–8.9 h; P trend = 0.32). Conclusion: We demonstrated that the higher CKD prevalence estimates were found in very short (≤5 h) and long (9.0–10.9 h) sleep durations in an apparently healthy population aged ≥18 years in the USA. This prevalence of CKD is further increased in those whose sleep duration exceeds 11 h. Our cross-sectional analyses clarified the U-shaped temporal relationship between sleep duration and CKD.