Making Sleep Recovery a Priority on the Weekend Could Lower CKD Risk

For many adults who fall short on sleep during the workweek, modest weekend recovery sleep may be linked to a lower prevalence of chronic kidney disease (CKD).1 An analysis of nationally representative survey data, published in Renal Failure, found that modest weekend catch-up sleep was associated with a lower prevalence of CKD among adults who reported short weekday sleep duration.

Modest weekend sleep recovery may reduce chronic kidney disease risk, especially for those with short weekday sleep duration. | Image credit: Pixel-Shot - stock.adobe.com

Rationale for Examining Sleep Patterns in CKD

CKD affects more than 10% of adults worldwide and remains closely linked to cardiometabolic conditions such as diabetes, hypertension, and obesity.2 Beyond these established risk factors, sleep duration and sleep-related behaviors have increasingly been recognized as contributors to kidney health. Prior studies have associated short sleep, long sleep, insomnia, and snoring with impaired kidney function and proteinuria.1

However, most research has focused on average nightly sleep duration and has not accounted for compensatory sleep behaviors. Weekend catch-up sleep (WCS)—defined as longer sleep duration on weekends compared with weekdays—is common among working adults and has been associated with metabolic and cardiovascular outcomes. Its relationship with CKD, however, has remained poorly characterized, prompting investigators to explore whether compensatory sleep may modify CKD risk.

Data Source and Study Population

The study used data from the National Health and Nutrition Examination Survey (NHANES) 2017 to 2020 cycles, which provide a nationally representative sample of noninstitutionalized US adults. Due to disruptions related to the COVID-19 pandemic, data from 2019 to early 2020 were combined with the 2017 to 2018 cycle.

After excluding individuals with missing data on sleep habits, kidney measures, or key covariates, the final analytic sample included 4942 adults 20 years or older, representing approximately 156 million US adults. Of these participants, 51.2% were women, and the mean age was 46.8 years.

CKD was defined using standard clinical criteria: an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 or a urine albumin-to-creatinine ratio of at least 30 mg/g.

Measurement of Weekend Catch-Up Sleep

Sleep duration was assessed using self-reported weekday and weekend bedtimes and wake times. Weekend catch-up sleep was calculated as the difference between weekend and weekday sleep duration. Participants were grouped by WCS duration: less than 1 hour (reference), 1 to less than 2 hours, 2 to less than 3 hours, and 3 hours or more.

Multivariable logistic regression models adjusted for demographic factors, socioeconomic status, smoking and alcohol use, body mass index (BMI), diabetes, hypertension, serum sodium and potassium levels, and weekday sleep duration.

Key Results and CKD Associations

Overall, 822 participants (16.7%) met criteria for CKD. Adults with CKD were older and more likely to have diabetes, hypertension, higher BMI, lower income, and lower educational attainment compared with those without CKD. They also reported shorter weekday sleep duration and less weekend catch-up sleep.

In fully adjusted analyses, the presence of any weekend catch-up sleep was not independently associated with CKD prevalence (adjusted OR [AOR], 0.86; 95% CI, 0.61-1.22). However, when WCS duration was examined categorically, a significant association emerged.

Adults who reported 2 to less than 3 hours of weekend catch-up sleep had a significantly lower prevalence of CKD compared with those reporting less than 1 hour of WCS (AOR, 0.44; 95% CI, 0.21-0.88). No statistically significant associations were observed for shorter (1-2 hours) or longer (≥3 hours) WCS durations after full adjustment.

Findings Across Key Subgroups

Subgroup analyses demonstrated that the inverse association between WCS and CKD was most evident among adults who slept fewer than 7 hours on weekdays. Significant negative associations were also observed among adults younger than 60 years, across BMI categories, and among both men and women.

The investigators emphasized that sleep distribution—not simply total sleep duration—may be relevant for kidney health. As stated in the report, “when weekday sleep duration is <7 h, weekend catch-up sleep of 2–3 h is strongly associated with a lower prevalence of CKD.”

The authors noted several limitations. Sleep duration was self-reported, which introduced the potential for recall bias and misclassification. The cross-sectional design limited the ability to determine causality or temporal relationships between sleep behavior and kidney outcomes. Residual confounding from unmeasured factors, such as occupational schedules, seasonal variation, or regional differences, could not be excluded.

Despite these, the study benefited from a large, nationally representative sample and robust multivariable adjustment, supporting its relevance to US adult populations.

The findings suggested that moderate weekend sleep recovery may partially offset the adverse effects of weekday sleep restriction on kidney health. However, the investigators cautioned that longitudinal studies using objective sleep measures are needed before weekend catch-up sleep can be considered a target for CKD prevention strategies.

References

1. Chen S, Zhang T, Gao H, Zhang J. Association between weekend catch-up sleep and chronic kidney disease: insights from NHANES 2017–2020. Ren Fail. 2025;47(1):2461682. doi:10.1080/0886022X.2025.2461682

2. Hannan M, Ansari S, Meza N, et al. Risk factors for CKD progression: overview of findings from the CRIC study. Clin J Am Soc Nephrol. 2021;16(4):648-659. doi:10.2215/CJN.07830520