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Sleep. 2019 Feb 1;42(2). doi: 10.1093/sleep/zsy210.

Short sleep duration is associated with inadequate hydration: cross-cultural evidence from US and Chinese adults.

Author information

Department of Biobehavioral Health, Pennsylvania State University, State College, PA.
Department of Anthropology, Pennsylvania State University, State College, PA.
Division of Sleep Medicine, Harvard Medical School, Harvard University, Cambridge, MA.
Department of Nephrology, Kailuan General Hospital, Tangshan, China.
Department of Cardiology, Kailuan Hospital, Tangshan, China.
Department of Nutrition, Pennsylvania State University, State College, PA.


Study Objectives:

Short and long sleep durations are linked to reduced kidney function, but little research has examined how sleep is associated with hydration status. Our aim was to assess the relationship between sleep duration and urinary hydration biomarkers among adults in a cross-cultural context.


Three samples of adults aged ≥20 years were analyzed: 2007-2008 National Health and Nutrition Examination Survey (NHANES; n = 4680), 2009-2012 NHANES (n = 9559), and 2012 cross-sectional wave of the Chinese Kailuan Study (n = 11903), excluding pregnant women and adults with failing kidneys. We estimated multiple linear regression models between self-reported usual night-time sleep duration (<6, 6, 7, 8 (reference), and ≥9 hr/day) and urine specific gravity (Usg) and urine osmolality (Uosm) as continuous variables and logistic regression models dichotomized as inadequate hydration (>1.020 g/mL; >831 mOsm/kg). In primary analyses, we estimated models excluding diabetes and diuretic medications for healthier subpopulations (NHANES, n = 11353; Kailuan, n = 8766).


In the healthier NHANES subset, 6 hr was associated with significantly higher Usg and odds of inadequate hydration (adjusted OR: 1.59, 95% CI: 1.25, 2.03) compared with 8 hr. Regression results were mixed using Uosm, but in the same direction as Usg. Among Chinese adults, short sleep duration (<6 and 6 hr) was associated with Usg and higher likelihood of inadequate hydration (6 hr adjusted OR: 1.42, 95% CI: 1.26, 1.60). No consistent association was found with sleeping ≥9 hr.


Short sleep duration was associated with higher odds of inadequate hydration in US and Chinese adults relative to sleeping 8 hr.


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