@article{2106fbc3186640039227d886288cec13,
title = "Habitual sleep and kidney function in chronic kidney disease: the Chronic Renal Insufficiency Cohort study",
abstract = "Physiological evidence suggests that sleep modulates kidney function. Our objective was to examine the cross-sectional association between kidney function and objectively-estimated habitual sleep duration, quality and timing in a cohort of patients with mild to moderate chronic kidney disease. This study involved two US clinical centers of the Chronic Renal Insufficiency Cohort (CRIC) study, including 432 participants in a CRIC ancillary sleep study. Habitual sleep duration, quality and timing were measured using wrist actigraphy for 5–7 days. Validated sleep questionnaires assessed subjective sleep quality, daytime sleepiness and risk of sleep apnea. Kidney function was assessed with the estimated glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation, and the urinary protein to creatinine ratio. Lower estimated glomerular filtration rate was associated with shorter sleep duration (−1.1 mL min−1 1.73 m−2 per hour less sleep, P = 0.03), greater sleep fragmentation (−2.6 mL min−1 1.73 m−2 per 10% higher fragmentation, P < 0.001) and later timing of sleep (−0.9 mL min−1 1.73 m−2 per hour later, P = 0.05). Higher protein to creatinine ratio was also associated with greater sleep fragmentation (approximately 28% higher per 10% higher fragmentation, P < 0.001). Subjective sleep quality, sleepiness and persistent snoring were not associated with estimated glomerular filtration rate or protein to creatinine ratio. Thus, worse objective sleep quality was associated with lower estimated glomerular filtration rate and higher protein to creatinine ratio. Shorter sleep duration and later sleep timing were also associated with lower estimated glomerular filtration rate. Physicians treating patients with chronic kidney disease should consider inquiring about sleep and possibly sending for clinical sleep assessment. Longitudinal and interventional trials are needed to understand causal direction.",
keywords = "circadian rhythms, nephrology, proteinuria, renal",
author = "{CRIC Study Investigators} and Knutson, {Kristen L.} and James Lash and Ricardo, {Ana C.} and James Herdegen and Thornton, {J. D.} and Mahboob Rahman and Nicolas Turek and Janet Cohan and Appel, {Lawrence J.} and Bazzano, {Lydia A.} and Tamura, {Manjula K.} and Steigerwalt, {Susan P.} and Weir, {Matthew R.} and {Van Cauter}, Eve",
note = "Funding Information: Funding for the CRIC Study was obtained under a cooperative agreement from the US National Institute of Diabetes and Digestive and Kidney Diseases (U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK0 61028, U01DK060980, U01DK060963 and U01DK060902). Funding for the CRIC Sleep Ancillary study was obtained through an award from the National Institutes of Health (R01DK0716960). In addition, this work was supported in part by: Clinical and Translational Science Collaborative of Cleveland, UL1TR000439 from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health and NIH roadmap for Medical Research, University of Illinois at Chicago CTSA UL1RR029879. Dr Knutson is also supported by the NIDDK R01DK095207. Dr Lash is funded by the NIDDK K24D K092290. Dr Ricardo is funded by the NIDDK K23DK094829. These funders played no role in the study design, data collection, data analysis, data interpretation or manuscript preparation. Funding Information: Kristen L. Knutson: National Sleep Foundation Poll Fellow; James Lash: none; Ana C. Ricardo: none; James Herdegen: none; J. Daryl Thornton: none; Mahboob Rahman: none; Nicolas Turek: none; Janet Cohan: none; Lawrence J. Appel: none; Lydia A. Bazzano: none; Manjula Kurella Tamura: none; Susan P. Steigerwalt: PI for a Medtronic SPYRAL trial (but no direct compensation to her); Matthew R. Weir: ad hoc scientific advisor to Janssen, Astra Zeneca, Boehringer-Ingelheim, MSD, Boston Scientific, Sanofi; Eve Van Cauter: consultant for Philips/Respironics for devices that may improve sleep quality, investigator-initiated grant support from Merck and Astra-Zeneca. Funding Information: Funding for the CRIC Study was obtained under a cooperative agreement from the US National Institute of Diabetes and Digestive and Kidney Diseases (U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963 and U01DK060902). Funding for the CRIC Sleep Ancillary study was obtained through an award from the National Institutes of Health (R01DK0716960). In addition, this work was supported in part by: Clinical and Translational Science Collaborative of Cleveland, UL1TR000439 from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health and NIH roadmap for Medical?Research, University of Illinois at Chicago CTSA UL1RR029879. Dr Knutson is also supported by the NIDDK R01DK095207. Dr Lash is funded by the NIDDK K24DK092290. Dr Ricardo is funded by the NIDDK K23DK094829. These funders played no role in the study design, data collection, data analysis, data interpretation or manuscript preparation. Publisher Copyright: {\textcopyright} 2017 European Sleep Research Society",
year = "2018",
month = apr,
doi = "10.1111/jsr.12573",
language = "English (US)",
volume = "27",
pages = "281--289",
journal = "Journal of Sleep Research",
issn = "0962-1105",
publisher = "Wiley-Blackwell",
number = "2",
}