Multiple, objectively measured sleep dimensions including hypoxic burden and chronic kidney disease: findings from the Multi-Ethnic Study of Atherosclerosis
dc.contributor.author | Jackson, Chandra L | |
dc.contributor.author | Umesi, Chizoba | |
dc.contributor.author | Gaston, Symielle A | |
dc.contributor.author | Azarbarzin, Ali | |
dc.contributor.author | Lunyera, Joseph | |
dc.contributor.author | McGrath, John A | |
dc.contributor.author | Jackson Ii, W Braxton | |
dc.contributor.author | Diamantidis, Clarissa J | |
dc.contributor.author | Boulware, Ebony | |
dc.contributor.author | Lutsey, Pamela L | |
dc.contributor.author | Redline, Susan | |
dc.date.accessioned | 2020-12-09T23:34:37Z | |
dc.date.available | 2020-12-09T23:34:37Z | |
dc.date.updated | 2020-12-09T23:34:36Z | |
dc.description.abstract | <jats:sec><jats:title>Background</jats:title><jats:p>Poor sleep may contribute to chronic kidney disease (CKD) through several pathways, including hypoxia-induced systemic and intraglomerular pressure, inflammation, oxidative stress and endothelial dysfunction. However, few studies have investigated the association between multiple objectively measured sleep dimensions and CKD.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We investigated the cross-sectional association between sleep dimensions and CKD among 1895 Multi-Ethnic Study of Atherosclerosis Sleep Ancillary Study participants who completed in-home polysomnography, wrist actigraphy and a sleep questionnaire. Using Poisson regression models with robust variance, we estimated separate prevalence ratios (PR) and 95% CIs for moderate-to-severe CKD (glomerular filtration rate <60 mL/min/1.73 m<jats:sup>2</jats:sup> or albuminuria >30 mg/g) among participants according to multiple sleep dimensions, including very short (≤5 hours) sleep, Apnoea−Hypopnoea Index and sleep apnoea-specific hypoxic burden (SASHB) (total area under the respiratory event-related desaturation curve divided by total sleep duration, %min/hour)). Regression models were adjusted for sociodemographic characteristics, health behaviours and clinical characteristics.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 1895 participants, mean age was 68.2±9.1 years, 54% were women, 37% were white, 28% black, 24% Hispanic/Latino and 11% Asian. Several sleep metrics were associated with higher adjusted PR of moderate-to-severe CKD: very short versus recommended sleep duration (PR=1.40, 95% CI 1.06 to 1.83); SASHB (Box-Cox transformed SASHB: PR=1.06, 95% CI 1.02 to 1.12); and for participants in the highest quintile of SASHB plus sleep apnoea: PR=1.28, 95% CI 1.01 to 1.63.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Sleep apnoea associated hypoxia and very short sleep, likely representing independent biological mechanisms, were associated with a higher moderate-to-severe CKD prevalence, which highlights the potential role for novel interventions.</jats:p></jats:sec> | |
dc.identifier.issn | 0040-6376 | |
dc.identifier.issn | 1468-3296 | |
dc.identifier.uri | ||
dc.language | en | |
dc.publisher | BMJ | |
dc.relation.ispartof | Thorax | |
dc.relation.isversionof | 10.1136/thoraxjnl-2020-214713 | |
dc.title | Multiple, objectively measured sleep dimensions including hypoxic burden and chronic kidney disease: findings from the Multi-Ethnic Study of Atherosclerosis | |
dc.type | Journal article | |
duke.contributor.orcid | Lunyera, Joseph|0000-0002-9350-320X | |
duke.contributor.orcid | Diamantidis, Clarissa J|0000-0001-8212-6288 | |
duke.contributor.orcid | Boulware, Ebony|0000-0002-8650-4212 | |
pubs.organisational-group | Staff | |
pubs.organisational-group | Medicine, General Internal Medicine | |
pubs.organisational-group | Duke | |
pubs.organisational-group | Medicine | |
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | School of Medicine | |
pubs.publication-status | Published online |
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