{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:38:32Z","timestamp":1792517912450,"version":"4.5.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The complex interplay of multiple sleep factors may affect the risk of complications and mortality in the chronic kidney disease (CKD) population. However, few studies have examined multi-dimensional sleep health in CKD populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Our cohort study included 15,809 participants with laboratory-observed kidney dysfunction or a CKD diagnosis during 2006\u20132010 from the UK Biobank. Incidence of adverse outcomes was identified via the International Classification of Diseases, 10th Edition (ICD-10) till 2022. The multi-dimensional sleep health was evaluated through an\n                      <jats:italic>a priori<\/jats:italic>\n                      sleep health score (SHS) and sleep health cluster categorized by latent class analysis. The relationships between multi-dimensional sleep health, each sleep factor, and outcomes in CKD were estimated through Cox proportional hazards models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2,416 deaths, 2,343 anemia, 4,087 CVD, 940 cognitive impairment, and 314 hyperparathyroidism occurred during the follow-up. After adjusting for potential confounders, higher SHS was significantly associated with decreased risks of anemia, CVD, and hyperparathyroidism (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Severe insomnia with short or long sleep duration and severe disturbed sleep with multiple dysfunctions were significantly associated with 19\u201354% higher risks of anemia, CVD and hyperparathyroidism. Each sleep factor indicated great heterogeneity in association with adverse outcomes in the CKD population, while gender and kidney function interact with some of these exposures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Poor multi-dimensional sleep health, either estimated by SHS or characterized by sleep clusters, was associated with poor prognosis in the CKD population. The specific sleep profiles in the CKD population contribute to pinpointing high-risk subgroups and providing targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1889689","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:32Z","timestamp":1787027312000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multi-dimensional sleep patterns predict complications and mortality in chronic kidney disease patients: a prospective study from the UK Biobank"],"prefix":"10.3389","volume":"14","author":[{"given":"Kaixin","family":"Lei","sequence":"first","affiliation":[{"name":"The Center of Gerontology and Geriatrics, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]},{"name":"West China School of Medicine, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiameng","family":"Li","sequence":"additional","affiliation":[{"name":"The Center of Gerontology and Geriatrics, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifan","family":"Xu","sequence":"additional","affiliation":[{"name":"West China School of Medicine, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Teng","sequence":"additional","affiliation":[{"name":"West China School of Medicine, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Lu","sequence":"additional","affiliation":[{"name":"National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxia","family":"Qiao","sequence":"additional","affiliation":[{"name":"Mental Health Center and Psychiatric Laboratory, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Guo","sequence":"additional","affiliation":[{"name":"The Center of Gerontology and Geriatrics, Sichuan University West China Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.kint.2018.04.011","article-title":"Analysis of the global burden of disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016","volume":"94","author":"Xie","year":"2018","journal-title":"Kidney Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2537916","DOI":"10.1080\/07853890.2025.2537916","article-title":"Temporal trends and machine learning prediction for chronic kidney disease due to hypertension in young adults from 1990 to 2021: an analysis of the global burden of disease study 2021","volume":"57","author":"Miao","year":"2025","journal-title":"Ann Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.1016\/s0140-6736(25)01330-3","article-title":"Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories and 660 subnational locations, 1950-2023: a demographic analysis for the global burden of disease study 2023","volume":"406","year":"2025","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.2215\/cjn.0000000947","article-title":"Cardiac biomarkers in chronic kidney disease: signal or noise?","volume":"21","author":"de Wolski","year":"2025","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"106506","DOI":"10.1016\/j.ejim.2025.106506","article-title":"Anemia in cardiorenal disease: from pathogenesis to treatment","author":"Heng","year":"2025","journal-title":"Eur J Intern Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1681\/asn.2012050536","article-title":"Cognitive disorders and dementia in CKD: the neglected kidney-brain axis","volume":"24","author":"Bugnicourt","year":"2013","journal-title":"J Am Soc Nephrol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4187","DOI":"10.1097\/js9.0000000000002510","article-title":"Asian consensus statement of experts on thermal ablation for secondary hyperparathyroidism in chronic kidney disease","volume":"111","author":"Chai","year":"2025","journal-title":"Int J 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Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1007\/s11336-023-09929-2","article-title":"A two-step estimator for multilevel latent class analysis with covariates","volume":"88","author":"Di Mari","year":"2023","journal-title":"Psychometrika"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1161\/cir.0000000000001078","article-title":"Life's essential 8: updating and enhancing the American Heart Association's construct of cardiovascular health: a presidential advisory from the American Heart Association","volume":"146","author":"Lloyd-Jones","year":"2022","journal-title":"Circulation"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1161\/circulationaha.109.192703","article-title":"Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic impact goal through 2020 and 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autophagy induces podocyte injury and proteinuria","volume":"105","author":"Wang","year":"2024","journal-title":"Kidney Int"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.2215\/cjn.01340118","article-title":"Sleep quality and sleep duration with CKD are associated with progression to ESKD","volume":"13","author":"Yamamoto","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"885","DOI":"10.2215\/cjn.09270816","article-title":"Sleep and CKD in Chinese adults: a cross-sectional study","volume":"12","author":"Li","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaf067","article-title":"Patient and caregiver perspectives on mental health in children and adolescents with chronic kidney disease","volume":"18","author":"Torrisi","year":"2025","journal-title":"Clin Kidney 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