{ "abstract": "Rationale & objective\n\nInsomnia and excessive daytime sleepiness (EDS) are common in patients with chronic kidney disease (CKD), but their determinants are poorly understood. We analyzed multiple factors likely to affect sleep with the aim of disentangling the contributions of CKD markers and symptoms from those of social factors, lifestyle, comorbid conditions, and drug-induced effects, with the latter 2 highly prevalent in this population.Study design\n\nProspective cohort study.Setting & participants\n\nIn total, 2,765 patients with CKD stages 2-5 not receiving dialysis (mean age, 67 ± 13 years; 66% men) from a representative sample of 40 nephrology clinics in France.Exposures\n\nAlbuminuria, estimated glomerular filtration rate, CKD symptoms, lifestyle, comorbid conditions, and medications collected annually.Outcomes\n\nInsomnia and EDS ≥ 3 times/week in the past 3 months assessed with a standardized questionnaire at baseline, 1-, 3-, and 5-year follow-ups, providing 7,264 observations overall.Analytical approach\n\nAdjusted odds ratios of insomnia and EDS associated with time-updated exposures estimated with mixed effects logistic regressions.Results\n\nBaseline prevalence of reported insomnia was 22% (95% confidence interval, 21%-24%) and that of EDS, 15% (14%-16%). Based on the 7,264 observations, neither prevalence was associated with albuminuria after adjustment for age and gender. The odds ratio of EDS alone increased significantly with decreasing estimated glomerular filtration rate, 1.16 (1.05-1.28 mL/min/1.73 m²) per 10 mL/min/1.73 m², independent of social factors, physical activity, obesity, heart failure, and long half-life benzodiazepine use. It was no longer significant after adjustment for fatigue, which displayed a strong dose-effect relation with EDS, depression, insomnia, and sleep apnea. Insomnia prevalence increased strongly with severity of cramps, itching, and stress, independent of other determinants including female gender, heart failure, thyroid hormone use, depression, and sleep apnea.Limitations\n\nSelf-reported sleep disturbances and limited longitudinal inference.Conclusions\n\nThis study highlights the multifactorial nature of sleep disturbances in CKD and the potentially modifiable contribution of CKD symptoms and drug-induced effects.", "abstract_shown": true, "affiliations": [ "Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France.", "University of Montpellier, Institute for Neurosciences of Montpellier (INM), Inserm, Montpellier, France.", "Service de Santé Publique, Epidémiologie - Maison Régionale de la Recherche Clinique, CHU Lille, Lille, France.", "UMR1167 RIDAGE, Institut Pasteur de Lille, Inserm, Univ Lille, Lille, France.", "Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, Amiens, France.", "MP3CV Laboratory, Jules Verne University of Picardie, Amiens, France.", "CHRU-Nancy, INSERM, Université de Lorraine, CIC-1433 Epidémiologie Clinique, Nancy, France.", "UMR 1319 INSPIIRE, Inserm, Université de Lorraine, Nancy, France.", "Department of Nephrology, CHU Lyon-Sud, Université de Lyon, Lyon, France.", "Inserm U1060, CARMEN, Lyon, France.", "Association pour l'Utilisation du Rein Artificiel (AURA) Paris, and Nephrology Department, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.", "ClinEpi Program Area, Arbor Research Collaborative for Health, Ann Arbor, MI USA.", "Service de Néphrologie, CHRU de Nancy, F-54000 Vandoeuvre-lès-Nancy, France." ], "article_type": "research article", "arxiv": null, "author_total": 14, "authors": [ { "affs": [ 0 ], "name": "Bénédicte Stengel" }, { "affs": [ 0 ], "name": "Emilie Moutard", "orcid": "0009-0006-6329-9339" }, { "affs": [ 0 ], "name": "Marie Metzger" }, { "affs": [ 1 ], "name": "Isabelle Jaussent" }, { "affs": [ 2, 3 ], "name": "Aghilès Hamroun" }, { "affs": [ 4, 5 ], "name": "Solène M Laville" }, { "affs": [ 6, 7 ], "name": "Abdou Omorou" }, { "affs": [ 8, 9 ], "name": "Denis Fouque" }, { "affs": [ 0, 10 ], "name": "Ziad A Massy" }, { "affs": [ 11 ], "name": "Roberto Pecoits-Filho" }, { "affs": [ 7, 12 ], "name": "Luc Frimat" }, { "affs": [ 0 ], "name": "Natalia Alencar de Pinho" }, { "affs": [ 4, 5 ], "name": "Sophie Liabeuf" }, { "name": "CKD-REIN study investigators" } ], "bibtex": "https://research.draconitic.com/paper/fbx4994e1hxcc.bib", "cited_by": 0, "doi": "10.1016/j.xkme.2026.101530", "fulltext_url": "https://europepmc.org/articles/PMC13679367", "id": "fbx4994e1hxcc", "issns": [ "2590-0595" ], "landing_url": "https://u-picardie.hal.science/hal-05758416v1", "language": "en", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "hal", "0.sdv" ], [ "hal", "1.sdv.mhep" ], [ "hal", "2.sdv.mhep.un" ], [ "openalex", "3205|Sleep and related disorders" ] ], "openalex": "W7213303644", "pdf_url": "https://europepmc.org/articles/PMC13679367?pdf=render", "pmcid": "PMC13679367", "pmid": "42899186", "published": "2026-09-15", "publisher": "[Cambridge, MA] : Elsevier Inc., [2019]-", "ris": "https://research.draconitic.com/paper/fbx4994e1hxcc.ris", "sources": [ { "first_seen": "2026-10-30T12:17:37Z", "native_id": "hal-05758416", "source": "hal", "url": "https://u-picardie.hal.science/hal-05758416v1" }, { "first_seen": "2026-10-30T12:19:41Z", "native_id": "MED:42899186", "source": "europepmc", "url": "https://europepmc.org/article/MED/42899186" } ], "subjects": [ { "field": "biology", "origin": "hal:0.sdv", "subfield": "general" }, { "field": "medicine", "origin": "hal:1.sdv.mhep", "subfield": "general" } ], "title": "Sleep Disturbances in Chronic Kidney Disease – The CKD-REIN Cohort Study", "title_text": "Sleep Disturbances in Chronic Kidney Disease – The CKD-REIN Cohort Study", "type": "peer-reviewed", "updated_at": "2026-10-30T12:19:41Z", "url": "https://research.draconitic.com/paper/fbx4994e1hxcc", "venue": "Kidney medicine", "versions": [] }