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Prevalence of Self-Reported Sleep Disorder and Nocturia Among U.S. Adults with and without CKD

Prevalence of Self-Reported Sleep Disorder and Nocturia Among U.S. Adults with and without CKD

In 2017–March 2020, self-reported sleep disorders and the symptom of nocturia (increased urination at night) were frequently reported in the U.S. population among adults with or without chronic kidney disease (CKD). Nocturia is more commonly reported in adults with CKD than without CKD. Prevalence of self-reported sleep disorders is higher in the most recent years in adults both with and without CKD.

Data Source: NHANES

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A sleep disorder is defined as a self-reported positive response to ever being told by your doctor you have a sleep disorder. Sleep disorder data are not yet available for the 2017–March 2020 cycle. Data are not adjusted.

NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center.

Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.

FieldData
Description of Measure

Prevalence of self-reported sleep disorder and nocturia among persons with and without CKD.

Data Set

National Health and Nutrition Examination Survey (NHANES).

Population

Noninstitutionalized U.S. adults aged ≥ 18 years, pregnant women excluded.

Years Included

2005–March 2020.

Numerator

Adults aged ≥ 18 years who self-report either having a sleep disorder or nocturia.

Denominator

Adult aged ≥ 18 years with serum creatinine and urine albumin measurements who completed the sleep disorders questionnaire.

Definition of CKD and CKD Stage

CKD is defined by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Stage 1: eGFR ≥ 90 ml/min/1.73 m² and albuminuria; Stage 2: eGFR 60–89 ml/min/1.73 m² and albuminuria; Stage 3: eGFR 30–59 ml/min/1.73 m²; Stage 4: 15–29 ml/min/1.73 m²; Stage 5: excluded. Estimates are based on single estimates of eGFR and UACR.

Estimated glomerular filtration rate (eGFR)

Based on the CKD-EPI equation for calibrated creatinine: eGFR=141 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20 x 0.993**age x (1.018 if female) x (1.159 if a Black person).

κ = 0.7 if female and 0.9 if male
α = -0.329 if female and -0.411 if male
** = raise to the power

Albuminuria

UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.

Serum Creatinine

Serum creatinine values used for eGFR calculation are standardized against isotope dilution mass spectrometry (IDMS).

Urine Albumin

Measured in random urine collection by fluorescent immunoassay.

Sleep Disorder

Self-reported affirmative response to ever being told by doctor have a sleep disorder.

Nocturia

Self-reported response of 2 or more times to the question: “During the past 30 days, how many times per night did you most typically get up to urinate, from the time you went to bed at night until the time you got up in the morning?”

Limitations of Indicator

Data are self-reported and diagnosis information for sleep disorders is not available.

Analytical Considerations

Appropriate NHANES survey weights are used for all analyses; if relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.


eGFR Formula Disclaimer
At the time of the last data update in summer 2022, the race-free eGFR formula was newly recommended and impact on health outcomes is underway. To avoid inconsistent results caused by different formulae, stakeholders continued using the eGFR formula with race during this transition. Since then, comparisons have been made. The estimates for the current website launch are still based on analyses using the eGFR formula with race, however plan is to use race-free eGFR formula for the next data update and upcoming website launch in fall 2023.