How Poor Sleep Affects Chronic Kidney Disease

Poor sleep is common among patients with chronic kidney disease, as proven by previous studies. But what these few studies overlooked, however, is the effect of sleep on the progression of chronic kidney disease.


A paper published in the Journal of the American Society of Nephrology stated that people with chronic kidney disease are especially vulnerable to the harmful effects of poor sleep.


Poor Sleep Research

A research study conducted among 431 patients with chronic kidney disease examined the link between sleep duration and quality on the progression of the disease.


It was led by associate professor of medicine at the University of Illinois at Chicago College of Medicine Dr. Ana Ricardo, an associate professor of neurology and preventive medicine at Northwestern University Kristen Knutson.


Participants of the study, with a mean age of 60 years old, were asked to wear an accelerometer on the wrists for 5 days to an entire week. The device is designed to provide information on duration of sleep and periods of wakefulness as well as measure motion.


The participants, half of which have diabetes and 40% of which were women, were also asked to keep a sleep journal where the number of hours slept is logged in. For five years, participants were followed and monitored.


Dr. Ricardo said that their observation showed that “sleep is seriously impaired in these patients with chronic disease”.


The participants only sleep for an average of 6.5 hours per night, with 21% of the time spent on average in bed in wakeful periods. Sleep fragmentation or interrupted sleep also occurred which increased the risk of developing kidney failure.



Over the 5-year follow-up, the following results were revealed:


  • 70 of the participants developed a kidney failure
  • 48 of the participants died during the 5-year study
  • Steeper declines in kidney function over time were associated with higher sleep fragmentation and shorter sleep duration.


According to Dr. Ricardo, each hour less of sleep duration increases the risk of deterioration of kidney function over time”.


Another study entitled Sleep and Activity in Chronic Kidney Disease: A Longitudinal Study revealed different results, however.


Researchers studied control patients, those with chronic kidney disease, and those on hemodialysis through actigraphy.


The actigraph, a watch-sized device that monitors activity and studies BP and sleep, were worn for up to 7 days by control patients and those with chronic kidney disease, but only for approximately 2 days by those on hemodialysis. The 2-day span covers the entire interdialytic interval.


Throughout the duration of actigraphy, sleep and wake times were recorded in a diary, including rest per day, sleep per day, wake during rest per day, sleep onset latency, sleep efficiency, snooze time, and wake after sleep onset (WASO).



Fragmentation index is then calculated to determine the metric that provides an index of movement during rest.


This time, the result in terms of the effect of progression of kidney disease did not reveal any linear pattern nor are there cogent patterns that relate sleep quality to the different stages of chronic kidney disease.


However, it did support Dr. Ricardo’s observation about seriously impaired sleeping patterns among patients suffering from kidney problems.


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