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Sleep disturbances are linked to poorer kidney, cardiovascular, metabolic, and psychological outcomes in people living with both diabetes and chronic kidney disease.
Diabetes and chronic kidney disease (CKD) already create a high-risk clinical combination, but disrupted sleep may further complicate disease management. Novel evidence indicates that problems ranging from obstructive sleep apnea (OSA) and insomnia to unusually short or long sleep duration are associated with poorer health outcomes in this population.
Lee et al. systematically reviewed the available evidence on sleep disturbances (obstructive sleep apnea, insomnia, short or long sleep duration) in individuals with comorbid diabetes and CKD. The review included 7 studies, comprising 4 cross-sectional studies and 3 randomized controlled trials (RCTs), identified through searches of CINAHL, EMBASE, MEDLINE-Ovid, and Web of Science.
Across the included studies, patients with diabetes and CKD who experienced sleep disturbances had poorer renal function and higher body mass index (BMI), along with greater arterial stiffness, coronary calcification, and inflammatory marker levels. Sleep disturbances were also linked with a greater psychological burden, including anxiety and depression.
Interventions targeting sleep showed encouraging clinical effects. Continuous positive airway pressure (CPAP) in OSA sufferers was associated with reduced albuminuria and improved glycemic outcomes. Melatonin supplementation was also associated with better sleep quality and glycemic control, together with reduced psychological distress.
The findings position sleep as a potentially modifiable factor within the complex diabetes–CKD disease pathway. Rather than viewing poor sleep solely as a consequence of chronic illness, the authors suggest that identifying and tackling sleep disturbances could become part of broader strategies aimed at protecting renal, cardiovascular, metabolic, and psychological health.
Sleep and Breathing
The impact of sleep disturbances in individuals with comorbid diabetes and chronic kidney disease: a systematic review
Yewon Lee et al.
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