Are You Aware: Sleep Problems Are More Common in Adults With Chronic Kidney Disease

Chronic Kidney Disease (CKD) Surveillance System







Are You Aware: Quick Facts About Kidney Disease

Sleep Problems Are More Common in Adults With Chronic Kidney Disease

In the United States, it is estimated that about 37 million adults have chronic kidney disease (CKD).¹ Generally, sleep problems have been associated with higher mortality risk, chronic diseases such as heart disease, and progression of CKD.^2-4 As a considerable proportion of the US population has reported sleep problems, prevalence is generally higher in adults with CKD than adults without CKD.³ 

In the 2013‒2014 National Health and Nutrition Examination Survey, two in five (41.0%) adults with CKD stages 3 and 4 reported trouble sleeping compared with 29.2% in adults with CKD stages 1 and 2* and 27.1% in adults with no CKD. The percentage reporting sleep disorders was also higher in adults with CKD stages 3 and 4 (17.7%) and CKD stages 1 and 2 (13.6%) than in adults without CKD (9.6%). Nocturia (waking up during the night to urinate) was also more prevalent in adults with CKD—39.4% in CKD stages 3 and 4 and 38.7% in CKD stages 1 and 2—compared with 24.3% in adults with no CKD. On the other hand, inadequate sleep was similar among adults with and without CKD. 

The higher burden of sleep problems among adults with CKD, especially with stages 3 and 4, highlights the importance for early detection and management of these symptoms in the primary and specialty care settings.

*Adults aged 20 years or older with kidney damage (those having protein in the urine) (CKD stages 1 and 2) or with an estimated glomerular filtration rate (eGFR)—a measure of kidney function—between 15–59 mL/min/1.73 m² (CKD stages 3 and 4). The higher the stage, the more advanced the disease. Estimates are not adjusted for age. Adults with CKD stage 5 that is with kidney failure (eGFR <15 mL/min/1.73 m²), were excluded from this analysis. 

Trouble sleeping and doctor's recognition of sleep disorders were self-reported. Nocturia was defined as two or more episodes of urination that disrupted sleep per night on average. Inadequate sleep was defined as reported sleep of less than or equal to 6 hours per night on average.

References:

1. Centers for Disease Control and Prevention. Chronic Kidney Disease Basics website. https://www.cdc.gov/kidneydisease/basics.html. 

2. Centers for Disease Control and Prevention. Sleep and Sleep Disorders website. https://www.cdc.gov/sleep/index.html. 

3. Shieu M, Morgenstern H, Bragg-Gresham J, et al. US trends in prevalence of sleep problems and associations with chronic kidney disease and mortality. Kidney360. 2020;1(6):458–468. DOI: https://doi.org/10.34067/KID.0000862019.  

4. Molnar MZ, Mucsi I, Novak M, et al. Association of incident obstructive sleep apnea with outcomes in a large cohort of US veterans. Thorax. 2015;70(9):888–895. DOI: 10.1136/thoraxjnl-2015-206970.