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

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.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.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).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.