Koh Jin Hean, Yeo Brian Sheng Yep, Tan Timothy Wei En, See Mark Yong Siang, Ng Adele Chin Wei, Loh Shaun Ray Han, Gooley Joshua, Tan Chieh Suai, Toh Song Tar
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Clin Kidney J. 2024 Jul 11;17(8):sfae177. doi: 10.1093/ckj/sfae177. eCollection 2024 Aug.
Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease.
A systematic review of the Medline/PubMed, Embase, Cochrane Library, and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality.
In total, 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep durations of ≤4 hours (RR 1.41, 95% CI: 1.16 to 1.71, < 0.01), ≤5 hours (RR 1.46, 95% CI: 1.22 to 1.76, < 0.01), ≤6 hours (RR 1.18, 95% CI: 1.09 to 1.29, < 0.01), and ≤7 hours (RR 1.19, 95% CI: 1.12 to 1.28, < 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep durations of ≥8 hours (RR 1.15, 95% CI: 1.03 to 1.28, < 0.01) and ≥9 hours (RR 1.46, 95% CI: 1.28 to 1.68, < 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region, and BMI and an association with sleep duration and risk of incident chronic kidney disease.
Both short and long sleep durations were significantly associated with a higher risk of chronic kidney disease. Interventions targeted toward achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease.
已发表的文献表明,慢性肾脏病成年患者的睡眠时间和质量可能会受到影响。然而,这两者之间的关系仍存在争议。本系统评价和荟萃分析的目的是评估睡眠时间和质量对慢性肾脏病的影响。
对Medline/PubMed、Embase、Cochrane图书馆和CINAHL数据库进行系统评价,以查找有关睡眠时间和质量与慢性肾脏病之间关联的文章。主要结局是不同睡眠时间和质量的患者发生慢性肾脏病的风险比。
荟萃分析共纳入42项研究(2613971例患者),平均年龄为43.55±14.01岁。与7至8小时的参考睡眠时间相比,睡眠时间≤4小时(风险比1.41,95%置信区间:1.16至1.71,P<0.01)、≤5小时(风险比1.46,95%置信区间:1.22至1.76,P<0.01)、≤6小时(风险比1.18,95%置信区间:1.09至1.29,P<0.01)和≤7小时(风险比1.19,95%置信区间:1.12至1.28,P<0.01)均与新发慢性肾脏病风险增加显著相关。睡眠时间≥8小时(风险比1.15,95%置信区间:1.03至1.28,P<0.01)和≥9小时(风险比1.46,95%置信区间:1.28至1.68,P<0.01)也与新发慢性肾脏病风险增加显著相关。Meta回归未发现年龄、性别、地理区域和体重指数对睡眠时间与新发慢性肾脏病风险之间的关联有任何显著影响。
睡眠时间过短和过长均与慢性肾脏病风险较高显著相关。针对实现最佳睡眠时间的干预措施可能会降低新发慢性肾脏病的风险。