Zhang Xi-Zhe, Xiang Jiong-Ao, Xu Jun-Jie, Wang Wen-Feng, Li Yao-Dong
The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
Second Clinical College, Wuhan University, Wuhan, Hubei Province, China.
Ren Fail. 2025 Dec;47(1):2471008. doi: 10.1080/0886022X.2025.2471008. Epub 2025 Feb 27.
Both sleep disorders and chronic kidney disease (CKD) are recognized as significant public health concerns. In the general population, sleep disorders have been shown to be associated with frailty in the elderly. This study aims to evaluate the association between sleep duration and trouble sleeping with frailty in CKD patients, as well as the potential interactive effect between these two factors.
This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. Sleep duration and trouble sleeping was self-reported. Frailty was assessed using a 49-item frailty index. The associations between sleep duration, trouble sleeping, and frailty were analyzed using weighted multivariate logistic regression and restricted cubic splines. Subgroup analysis was conducted to determine the consistency of the study's conclusions across various subgroups.
A total of 5,211 adult CKD patients were included in this analysis. Regression analysis results indicated that short sleep duration (OR = 1.364, 95% CI: 1.152-1.616), long sleep duration (OR = 1.648, 95% CI: 1.259-2.157), and trouble sleeping (OR = 2.572, 95% CI: 2.102-3.147) were significantly associated with an increased risk of frailty in CKD patients, with an interaction between sleep duration and trouble sleeping. Subgroup analysis revealed that the effects of trouble sleeping and sleep duration on frailty symptoms in CKD patients exhibit significant variation across age groups ( < 0.05 for interaction), with no notable differences observed in other subgroups. RCS results demonstrated a U-shaped relationship between frailty and sleep duration, with the lowest risk of frailty at 7.12 h of sleep.
Our findings indicated that both sleep duration and trouble sleeping were significantly associated with frailty in CKD patients, with a notable interaction between these two factors. Therefore, prevention and intervention strategies for frailty in CKD patients should address multiple aspects of sleep health.
睡眠障碍和慢性肾脏病（CKD）均被视为重大的公共卫生问题。在普通人群中，睡眠障碍已被证明与老年人的虚弱相关。本研究旨在评估CKD患者的睡眠时间和睡眠困难与虚弱之间的关联，以及这两个因素之间潜在的交互作用。
这项横断面研究分析了2005年至2018年美国国家健康与营养检查调查（NHANES）的数据。睡眠时间和睡眠困难通过自我报告获得。使用一个包含49个项目的虚弱指数评估虚弱情况。采用加权多变量逻辑回归和受限立方样条分析睡眠时间、睡眠困难与虚弱之间的关联。进行亚组分析以确定研究结论在各个亚组中的一致性。
本分析共纳入5211例成年CKD患者。回归分析结果表明，睡眠时间短（OR = 1.364，95%CI：1.152 - 1.616）、睡眠时间长（OR = 1.648，95%CI：1.259 - 2.157）以及睡眠困难（OR = 2.572，95%CI：2.102 - 3.147）均与CKD患者虚弱风险增加显著相关，且睡眠时间和睡眠困难之间存在交互作用。亚组分析显示，睡眠困难和睡眠时间对CKD患者虚弱症状的影响在不同年龄组间存在显著差异（交互作用P < 0.05），在其他亚组中未观察到明显差异。受限立方样条结果显示虚弱与睡眠时间之间呈U形关系，睡眠时间为7.12小时时虚弱风险最低。
我们的研究结果表明，睡眠时间和睡眠困难均与CKD患者的虚弱显著相关，且这两个因素之间存在显著的交互作用。因此，CKD患者虚弱的预防和干预策略应涉及睡眠健康的多个方面。
