Table 2.
Results from the cross-sectional analysis for CKD outcomes and survival analysis for incident ESKD outcome
| Outcome and Exposurea | Univariable Model | Multivariable Model 1b | Multivariable Model 2c | |||
|---|---|---|---|---|---|---|
| OR or HR (95% CI) | P Value | Adjusted OR or HR (95% CI) | P Value | Adjusted OR or HR (95% CI) | P Value | |
| Total participants, n=465,814 | ||||||
| CKD stages 3–5 (N of patients =11,103) | ||||||
| Short sleep, <6 h | 1.28 (1.19 to 1.39) | <0.001 | 1.27 (1.17 to 1.37) | <0.001 | 1.07 (0.99 to 1.16) | 0.08 |
| Long sleep, ≥9 h | 2.05 (1.94 to 2.17) | <0.001 | 1.50 (1.42 to 1.59) | <0.001 | 1.36 (1.28 to 1.44) | <0.001 |
| CKD with eGFR≥45 (N of patients =9184) | ||||||
| Short sleep, <6 h | 1.21 (1.11 to 1.32) | <0.001 | 1.19 (1.09 to 1.29) | <0.001 | 1.03 (1.21 to 1.38) | 0.56 |
| Long sleep, ≥9 h | 1.90 (1.79 to 2.02) | <0.001 | 1.41 (1.33 to 1.51) | <0.001 | 1.29 (1.12 to 1.38) | <0.001 |
| Incident ESKD (N of patients =404) | ||||||
| Short sleep, <6 h | 1.51 (1.04 to 2.19) | 0.03 | 1.41 (0.97 to 2.06) | 0.07 | 1.23 (0.85 to 0.80) | 0.28 |
| Long sleep, ≥9 h | 2.02 (1.52 to 2.69) | <0.001 | 1.24 (0.92 to 1.66) | 0.16 | 1.13 (0.84 to 1.52) | 0.41 |
| Participants who were men, n=213,512 | ||||||
| CKD stages 3–5 (N of patients =5208) | ||||||
| Short sleep, <6 h | 1.27 (1.13 to 1.42) | <0.001 | 1.38 (1.22 to 1.55) | <0.001 | 1.16 (1.03 to 1.31) | 0.02 |
| Long sleep, ≥9 h | 2.33 (2.15 to 2.52) | <0.001 | 1.53 (1.42 to 1.66) | <0.001 | 1.36 (1.25 to 1.48) | <0.001 |
| CKD with eGFR≥45 (N of patients =4175) | ||||||
| Short sleep, <6 h | 1.19 (1.04 to 1.36) | 0.01 | 1.30 (1.14 to 1.49) | <0.001 | 1.12 (0.98 to 1.28) | 0.10 |
| Long sleep, ≥9 h | 2.18 (2.00 to 2.39) | <0.001 | 1.44 (1.32 to 1.58) | <0.001 | 1.30 (1.19 to 1.43) | <0.001 |
| Incident ESKD (N of patients =259) | ||||||
| Short sleep, <6 h | 2.00 (1.30 to 3.09) | 0.002 | 1.94 (1.25 to 2.99) | 0.003 | 1.72 (1.11 to 2.67) | 0.01 |
| Long sleep, ≥9 h | 2.73 (1.96 to 3.80) | <0.001 | 1.61 (1.14 to 2.28) | 0.007 | 1.51 (1.07 to 2.14) | 0.02 |
| Participants who were women, n=252,302 | ||||||
| CKD stages 3–5 (N of patients n=5895) | ||||||
| Short sleep, <6 h | 1.30 (1.17 to 1.44) | <0.001 | 1.19 (1.07 to 1.32) | 0.001 | 1.02 (0.92 to 1.13) | 0.71 |
| Long sleep, ≥9 h | 1.83 (1.70 to 1.98) | <0.001 | 1.47 (1.35 to 1.59) | <0.001 | 1.34 (1.24 to 1.46) | <0.001 |
| CKD with eGFR≥45 (N of patients n=5009) | ||||||
| Short sleep, <6 h | 1.22 (1.08 to 1.36) | 0.001 | 1.11 (0.99 to 1.25) | 0.07 | 0.97 (0.86 to 1.09) | 0.62 |
| Long sleep, ≥9 h | 1.69 (1.55 to 1.84) | <0.001 | 1.38 (1.26 to 1.50) | <0.001 | 1.28 (1.17 to 1.40) | <0.001 |
| Incident ESKD (N of patients =145) | ||||||
| Short sleep, <6 h | 0.86 (0.40 to 1.84) | 0.69 | 0.80 (0.37 to 1.72) | 0.57 | 0.68 (0.31 to 1.47) | 0.32 |
| Long sleep, ≥9 h | 1.13 (0.64 to 2.01) | 0.67 | 0.74 (0.41 to 1.35) | 0.33 | 0.66 (0.36 to 1.21) | 0.18 |
Pooled results after multiple imputation by the chained equation method are presented. eGFR is in milliliters per minute per 1.73 m2. OR, odds ratio; HR, hazard ratio; 95% CI, 95% confidence interval.aThe reference group for the logistic regression and Cox regression analysis was the intermediate-sleep group (6–8 h of sleep). The CKD outcomes were analyzed by logistic regression analysis. In the analysis for CKD with eGFR≥45 ml/min per 1.73 m2 outcome, those with lower eGFR (<45 ml/min per 1.73 m2) were not included (n=1919), and we included those with CKD with ≥45 ml/min per 1.73 m2 (patients) or without CKD (controls) to limit the CKD outcome to those without profoundly reduced eGFR. The incident ESKD outcome was analyzed by Cox regression analysis, excluding 581 participants with eGFR<15 ml/min per 1.73 m2 or prevalent ESKD history.
Multivariable model 1 for CKD outcome was adjusted for age, sex, smoking history (nonsmoker, ex-smoker, or current smoker), habitual naps (never/rarely, sometimes, or usually), or snoring. When analyzing the incident ESKD outcome, the baseline eGFR and urine microalbumin-creatinine ratio were added to the model.
Multivariable model 2 for CKD outcome was adjusted for age, sex, body mass index, waist circumference, smoking history (nonsmoker, ex-smoker, or current smoker), frequency of moderate physical activity per week (days), previous history of cardiovascular disease (angina, heart attack, or stroke), hypertension, systolic BP, diastolic BP, diabetes mellitus, hemoglobin A1c, total cholesterol, LDL, HDL, and self-reported habitual naps (never/rarely, sometimes, or usually) or snoring. When analyzing the incident ESKD outcome, age, sex, baseline eGFR, urine microalbumin-creatinine ratio, body mass index, smoking history, history of cardiovascular disease, hypertension, diabetes mellitus, and habitual naps or snoring were adjusted for the multivariable model.