Association between sleep disorders and diabetic kidney disease among U.S. adults aged 45 and older: findings from the 2007–2014 NHANES

Abstract

Diabetic kidney disease (DKD) is a frequent microvascular manifestation of diabetes. However, the associations between sleep disorders, sleep duration time (SDT), and DKD remain inadequately understood. This study seeks to examine the associations of sleep-related factors with the prevalence of DKD among Americans aged 45 and older. A cross-sectional analysis was carried out utilizing the 2007–2014 National Health and Nutrition Examination Survey (NHANES) data. Four sleep-related variables were evaluated: continuous SDT, categorized SDT, self-reported sleep disorders, and clinically diagnosed sleep disorders. The associations of sleep-related factors with DKD were examined via weighted logistic regression models and subgroup analyses, with adjustments for multiple potential confounders. Possible nonlinear associations between SDT and DKD were explored using restricted cubic spline (RCS) functions. Propensity score matching (PSM) was applied to evaluate the robustness of the findings. 10,780 participants were included. The overall DKD prevalence was 11.5% (n = 1243). Both self-reported sleep disorders (Model 3: OR = 1.43, 95% CI 1.16–1.77, P < 0.05) and clinically diagnosed sleep disorders (Model 3: odds ratio (OR) = 1.56, 95% confidence interval (CI) 1.15–2.11, P < 0.05) were associated with a higher prevalence of DKD. Prolonged SDT (> 9 h) was also associated with a higher DKD prevalence (OR = 1.63, 95% CI 1.08–2.46, P < 0.05). RCS analysis demonstrated a U-shaped association between SDT and DKD (P for overall association = 0.001; P for nonlinearity < 0.001). In this cross-sectional analysis, sleep disorders and abnormal sleep duration were associated with DKD. Sleep-related factors may warrant consideration in the comprehensive clinical assessment of individuals with diabetes. Longitudinal studies are required to clarify temporal relationships.