Joint association of sleep onset time and sleep duration with depression in patients with chronic kidney disease: Insights from the NHANES 2015–2020

Background

The prevalence of depression among patients with chronic kidney disease (CKD) is high and closely related to poor prognosis. However, the association between sleep onset time, sleep duration, and depression in CKD patients has not been thoroughly studied.

Methods

This study utilized cross-sectional data from CKD patients who participated in the National Health and Nutrition Examination Survey from 2015 to 2020, analyzing their sleep onset time, sleep duration, and Patient Health Questionnaire-Nine. Logistic regression models and restricted cubic spline models were used to explore the association between sleep onset time, sleep duration, and depression in CKD patients.

Results

A total of 2141 CKD patients aged 20 and above were included in this study, among whom 246 (11.5 %) had depression. Compared to those reporting optimal sleep onset (22:00–23:59) and sufficient sleep duration (7–8 h), CKD patients with late sleep onset (≥24:00) and either insufficient (<7 h) or excessive (≥9 h) sleep had a significantly higher risk of depression, with adjusted OR of 2.03 (95 % CI:1.29–3.19) and 2.07 (95 % CI:1.07–4.00), respectively. Additionally, the association between sleep onset time, sleep duration, and depression showed a U-shaped pattern, with the inflection point for sleep onset time at 23:00 and for sleep duration at 7.5 h.

Conclusion

Inappropriate sleep onset time and sleep duration are significantly associated with depression in CKD patients. This association may be important to consider in clinical practice for the prevention and management of depressive symptoms in CKD patients.