Sasaki Sachiko, Yoshioka Eiji, Saijo Yasuaki, Bannai Akira, Kita Toshiko, Tamakoshi Akiko, Kishi Reiko
Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, 5-196-1 Kogane-chuo, Eniwa, 061-1449, Japan.
Sleep Breath. 2018 Mar;22(1):257-265. doi: 10.1007/s11325-017-1508-3. Epub 2017 May 22.
The role of insomnia in chronic kidney disease (CKD) is controversial. To date, there have been no prospective studies investigating insomnia, CKD and the effect of shift work. We assessed insomnia and CKD risk in a prospective, occupational cohort study.
A total of 3600 participants with normal kidney function were followed for an average of 4.4 years. Insomnia was assessed using the Athens Insomnia Scale (AIS). CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m at the first health examination. Cox proportional hazard regression models were used to estimate hazard ratios with 95% confidence intervals of insomnia for CKD development.
A total of 182 CKD cases were identified. After adjustment for potential confounders, we did not observe an association between insomnia (AIS score ≥6) and CKD. However, the AIS item of awakening during the night was associated with a significantly increased CKD risk (hazard ratio = 3.10, 95% confidence interval 1.68-5.30). In further analyses, having difficulty with sleep induction was associated with an increased CKD risk among shift workers (hazard ratio = 3.34, 95% confidence interval 1.22-8.31). This association was not present among non-shift workers.
Awakening during the night is associated with a moderately increased CKD risk.
失眠在慢性肾脏病（CKD）中的作用存在争议。迄今为止，尚无前瞻性研究调查失眠、CKD及轮班工作的影响。我们在一项前瞻性职业队列研究中评估了失眠与CKD风险。
对3600名肾功能正常的参与者进行了平均4.4年的随访。使用雅典失眠量表（AIS）评估失眠情况。CKD定义为首次健康检查时估计肾小球滤过率<60 mL/min/1.73 m²。采用Cox比例风险回归模型估计失眠导致CKD发生的风险比及95%置信区间。
共识别出182例CKD病例。在对潜在混杂因素进行调整后，我们未观察到失眠（AIS评分≥6）与CKD之间存在关联。然而，夜间觉醒这一AIS项目与CKD风险显著增加相关（风险比=3.10，95%置信区间1.68 - 5.30）。在进一步分析中，入睡困难与轮班工作者的CKD风险增加相关（风险比=3.34，95%置信区间1.22 - 8.31）。非轮班工作者中不存在这种关联。
夜间觉醒与CKD风险适度增加相关。
