Sleep Disturbances in Chronic Kidney Disease – The CKD-REIN Cohort Study
13 affiliations
- 1Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France.
- 2University of Montpellier, Institute for Neurosciences of Montpellier (INM), Inserm, Montpellier, France.
- 3Service de Santé Publique, Epidémiologie - Maison Régionale de la Recherche Clinique, CHU Lille, Lille, France.
- 4UMR1167 RIDAGE, Institut Pasteur de Lille, Inserm, Univ Lille, Lille, France.
- 5Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, Amiens, France.
- 6MP3CV Laboratory, Jules Verne University of Picardie, Amiens, France.
- 7CHRU-Nancy, INSERM, Université de Lorraine, CIC-1433 Epidémiologie Clinique, Nancy, France.
- 8UMR 1319 INSPIIRE, Inserm, Université de Lorraine, Nancy, France.
- 9Department of Nephrology, CHU Lyon-Sud, Université de Lyon, Lyon, France.
- 10Inserm U1060, CARMEN, Lyon, France.
- 11Association pour l'Utilisation du Rein Artificiel (AURA) Paris, and Nephrology Department, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.
- 12ClinEpi Program Area, Arbor Research Collaborative for Health, Ann Arbor, MI USA.
- 13Service de Néphrologie, CHRU de Nancy, F-54000 Vandoeuvre-lès-Nancy, France.
Abstract
Rationale & objective
Insomnia 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
Prospective cohort study.Setting & participants
In 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
Albuminuria, estimated glomerular filtration rate, CKD symptoms, lifestyle, comorbid conditions, and medications collected annually.Outcomes
Insomnia 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
Adjusted odds ratios of insomnia and EDS associated with time-updated exposures estimated with mixed effects logistic regressions.Results
Baseline 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
Self-reported sleep disturbances and limited longitudinal inference.Conclusions
This study highlights the multifactorial nature of sleep disturbances in CKD and the potentially modifiable contribution of CKD symptoms and drug-induced effects.
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BibTeX
@article{stengel2026sleep,
title = {{Sleep Disturbances in Chronic Kidney Disease – The CKD-REIN Cohort Study}},
author = {Bénédicte Stengel and Emilie Moutard and Marie Metzger and Isabelle Jaussent and Aghilès Hamroun and Solène M Laville and Abdou Omorou and Denis Fouque and Ziad A Massy and Roberto Pecoits-Filho and Luc Frimat and Natalia Alencar de Pinho and Sophie Liabeuf and CKD-REIN study investigators},
journal = {Kidney medicine},
year = {2026},
month = sep,
doi = {10.1016/j.xkme.2026.101530},
url = {https://u-picardie.hal.science/hal-05758416v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sleep Disturbances in Chronic Kidney Disease – The CKD-REIN Cohort Study
AU - Bénédicte Stengel
AU - Emilie Moutard
AU - Marie Metzger
AU - Isabelle Jaussent
AU - Aghilès Hamroun
AU - Solène M Laville
AU - Abdou Omorou
AU - Denis Fouque
AU - Ziad A Massy
AU - Roberto Pecoits-Filho
AU - Luc Frimat
AU - Natalia Alencar de Pinho
AU - Sophie Liabeuf
AU - CKD-REIN study investigators
PY - 2026
DA - 2026/09/15
JO - Kidney medicine
DO - 10.1016/j.xkme.2026.101530
UR - https://u-picardie.hal.science/hal-05758416v1
AB - Rationale & objective Insomnia 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 Prospective cohort study.Setting & participants In 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 Albuminuria, estimated glomerular filtration rate, CKD symptoms, lifestyle, comorbid conditions, and medications collected annually.Outcomes Insomnia 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 Adjusted odds ratios of insomnia and EDS associated with time-updated exposures estimated with mixed effects logistic regressions.Results Baseline 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 Self-reported sleep disturbances and limited longitudinal inference.Conclusions This study highlights the multifactorial nature of sleep disturbances in CKD and the potentially modifiable contribution of CKD symptoms and drug-induced effects.
SN - 2590-0595
ER -