The Association of Sleep Duration with the Risk of Chronic Kidney Disease: a Systematic Review and Meta-Analysis

Abstract

Background and hypothesis Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease. Methods A systematic review of the Medline/PubMed, Embase, Cochrane Library and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality. Results 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep duration of ≤ 4 hours (RR 1.41, 95% CI: 1.16 to 1.71, p < 0.01), ≤5 hours (RR 1.46, 95% CI: 1.22 to 1.76, p < 0.01), ≤6 hours (RR 1.18, 95% CI: 1.09 to 1.29, p < 0.01) and ≤ 7 hours (RR 1.19, 95% CI: 1.12 to 1.28, p < 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep duration of ≥ 8 hours (RR 1.15, 95% CI: 1.03 to 1.28, p < 0.01) and ≥ 9 hours (RR 1.46, 95% CI: 1.28 to 1.68, p < 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region and BMI and the association of sleep duration and risk of incident chronic kidney disease. Conclusion Both short and long sleep duration were significantly associated with a higher risk of chronic kidney disease. Interventions targeted towards achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease.