Association between sleep patterns and diagnosed chronic kidney disease: a cohort study in China

Background Chronic kidney disease (CKD) is a globally prevalent and progressive health condition, with increasing evidence indicating a significant association between sleep quality and renal health. This study aims to explore the relationship between sleep quality and the development of CKD and to assess how various sleep characteristics influence renal health. Methods This prospective cohort study included participants aged 30–79 years from 10 districts within the China Kadoorie Biobank. Sleep quality was evaluated using a standardized questionnaire that covered seven parameters, including delayed/disrupted sleep, waking early, sleep medication, daytime sleepiness, naps, snoring, and total sleep duration. Different sleep patterns were identified by k-prototype clustering analysis. Survival analysis and relative weight analysis (RWA) were employed to investigate the associations between sleep disturbances and the incidence of diagnosed CKD. Results Cluster analysis revealed three distinct sleep patterns. Compared with the Cluster1 (optimal sleep), Cluster 2 (frequent napping/snoring) (HR = 1.103, 95% CI: 1.027–1.185, p = 0.007) and Cluster 3 (short and fragmented sleep) (HR = 1.210, 95% CI: 1.129–1.297, p < 0.001) patterns were associated with a significantly increased risk of diagnosed CKD. However, after propensity score matching (PSM), the association for Cluster 2 was attenuated and no longer statistically significant, whereas the association for Cluster 3 remained robust. Of the seven sleep parameters, the top three contributors to diagnosed CKD risk were in order of importance as follows: snoring (RW = 2.59E-04, RS-RW = 55.49%, p < 0.05), total sleep duration (RW = 1.09E-04, RS-RW = 23.32%, p < 0.05), and daytime naps (RW = 4.12E-05, RS-RW = 8.81%, p < 0.05). Conclusion Unhealthy sleep patterns increased the risk of suffering from diagnosed CKD. Short and fragmented sleep showed the most robust association, whereas the association for frequent napping/snoring was attenuated after PSM. These findings highlight the importance of improving sleep quality and addressing sleep-related problems such as snoring may help reduce diagnosed CKD risk and promote overall kidney health.