title: Sleep Characteristics in Early Stages of Chronic Kidney Disease in the HypnoLaus Cohort.
abstract: OBJECTIVE
  To evaluate the association between early stages of chronic kidney disease (CKD) and sleep disordered breathing (SDB), restless legs syndrome (RLS), and subjective and objective sleep quality (SQ).
  
  
  METHODS
  Cross-sectional analysis of a general population-based cohort (HypnoLaus). 1,760 adults (862 men, 898 women; age 59.3 (± 11.4) y) underwent complete polysomnography at home.
  
  
  RESULTS
  8.2% of participants had mild CKD (stage 1-2, estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m(2) with albuminuria) and 7.8% moderate CKD (stage 3, eGFR 30-60 mL/min/1.73 m(2)). 37.3% of our sample had moderate-to-severe SDB (apnea-hypopnea index [AHI] ≥ 15/h) and 15.3% had severe SDB (AHI ≥ 30/h). SDB prevalence was positively associated with CKD stages and negatively with eGFR. In multivariate analysis, age, male sex, and body mass index were independently associated with SDB (all P < 0.001), but kidney function was not. The prevalence of RLS was 17.5%, without difference between CKD stages. Periodic leg movements index (PLMI) was independently associated with CKD stages. Subjective and objective SQ decreased and the use of sleep medication was more frequent with declining kidney function. Older age, female sex, and the severity of SDB were the strongest predictors of poor SQ in multivariate regression analysis but CKD stage was also independently associated with reduced objective SQ.
  
  
  CONCLUSIONS
  Patients with early stages of CKD have impaired SQ, use more hypnotic drugs, and have an increased prevalence of SDB and PLM. After controlling for confounders, objective SQ and PLMI were still independently associated with declining kidney function.
authors.affiliation: Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Adam
authors.initials: A
authors.lastname: Ogna
authors.affiliation: Service of Nephrology and Hypertension, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Valentina
authors.initials: V
authors.lastname: Forni Ogna
authors.affiliation: Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: José
authors.initials: J
authors.lastname: Haba Rubio
authors.affiliation: Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Nadia
authors.initials: N
authors.lastname: Tobback
authors.affiliation: Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Dana
authors.initials: D
authors.lastname: Andries
authors.affiliation: Department of Psychiatry, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Preisig
authors.affiliation: Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne (CHUV), Lausanne, Switzerland.|Center for Integrative Genomics, Lausanne University, Lausanne, Switzerland.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tafti
authors.affiliation: Department of Internal Medicine, Internal Medicine, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Vollenweider
authors.affiliation: Department of Internal Medicine, Internal Medicine, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Gerard
authors.initials: G
authors.lastname: Waeber
authors.affiliation: Department of Internal Medicine, Internal Medicine, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.affiliation: Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Heinzer
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D012727:Sex Characteristics; D012890:Sleep / Q000502:physiology*; D000068776:Sleep Aids, Pharmaceutical; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*
chemical_list: D000068776:Sleep Aids, Pharmaceutical
keywords: chronic kidney disease; periodic leg movements during sleep; polysomnography; restless legs syndrome; sleep apnea; sleep disordered breathing; sleep quality