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Trends in Prevalence of Self-Reported Sleep-Related Problems among U.S. Adults

The crude and age-standardized prevalence of sleep-related problems (sleep disorder, trouble sleeping, and nocturia) was higher among adults with CKD than among those without CKD. Among adults without or with CKD, prevalence of self-reported sleep disorders trended higher over time. Nocturia was more commonly reported in adults with CKD than those without CKD.

Data Source: NHANES

To view the prevalence of the three different sleep-related problems, select from the drop-down menu below. Sleep-related problems include sleep disorder, trouble sleeping, and nocturia.

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Prevalence of Self-Reported Sleep Disorder and Nocturia Among U.S. Adults with and without CKD by Overall and Sleep Disorder (%) National Health and Nutrition Examination Survey
Sleep Disorder	2005-2008	2009-2012	2013-2016
No CKD	7.1 (95% CI: 6.5-7.8)	7.5 (95% CI: 6.7-8.2)	9.4 (95% CI: 8.2-10.6)
CKD Stages 1–2	9.9 (95% CI: 6.9-12.8)	12.2 (95% CI: 8.5-16.0)	13.6 (95% CI: 9.0-18.2)
CKD Stages 3–5	9.2 (95% CI: 6.4-12.0)	12.3 (95% CI: 9.2-15.4)	16.5 (95% CI: 10.9-22.1)

Prevalence of Self-reported Sleep Disorder and Nocturia among U.S. Adults With and Without CKD by Overall and Sleep Disorder (%) National Health and Nutrition Examination Survey
Sleep Disorder	2005-2008	2009-2012	2013-2016
No CKD	7.3 (95% CI: 6.7-7.9)	7.7 (95% CI: 6.9-8.4)	9.5 (95% CI: 8.3-10.7)
CKD Stages 1–2	10.0 (95% CI: 6.9-13.1)	11.5 (95% CI: 7.9-15.0)	13.5 (95% CI: 8.9-18.2)
CKD Stages 3–5	6.8 (95% CI: 2.7-10.9)	12.0 (95% CI: 6.2-17.7)	14.6 (95% CI: 6.8-22.4)

A sleep disorder is defined as a self-reported positive response to the question: “Ever told by doctor have sleep disorder?”. Sleep disorder data are not available for the 2017–March 2020 cycle. Trouble sleeping is defined as a self-reported positive response to the question: “Ever told doctor had trouble sleeping?”. 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.

Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.

Field	Data
Description of Measure	Prevalence of self-reported sleep-related problems among U.S. adults.
Data Set	National Health and Nutrition Examination Survey (NHANES).
Population	Noninstitutionalized U.S. adults aged ≥ 18 years (sleep disorder and trouble sleeping) and ≥ 20 years (nocturia), pregnant women excluded.
Years Included	2005–March 2020.
Numerator	Adults aged ≥ 18 years who self-reported having a sleep disorder or trouble sleeping; adults aged ≥ 20 years who self-reported nocturia.
Denominator	Adults aged ≥ 18 years with complete serum creatinine and urine albumin measurements who completed the sleep disorders questionnaire.
Definition of CKD and CKD Stage	CKD is defined by an 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: eGFR < 15 ml/min/1.73 m². Estimates are based on single estimates of eGFR and UACR.
Estimated Glomerular Filtration Rate (eGFR)	Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]α x [max(serum creatinine/κ, 1)]-1.20 x 0.9938age x (1.012 if female). κ = 0.7 if female and 0.9 if male α = -0.241 if female and -0.302 if male = raise to the power
Albuminuria	Urine albumin to creatinine ratio (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 the question: “Have you ever been told by a doctor that you have a sleep disorder?”
Trouble Sleeping	Self-reported affirmative response to the question: “Have you ever told a doctor that you had trouble sleeping?”
Nocturia	Self-reported response of two 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?”
Age Standardization	Estimates were standardized to the 2010 U.S. Census population for adults. 18–39 years: 37.1%, 40–59 years: 38.1%, 60–69 years: 12.8%, and 70+ years: 12.0%.
Limitations of Indicator	Data are self-reported and diagnosis information for sleep disorders is not available.
Analytical Considerations	Appropriate NHANES survey weights were used for all analyses; if relative standard error was greater than 30%, the estimates were not shown. Serum creatinine measurements were assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.