Kidney Week

Abstract: SA-PO0485

Effect of Sleep Quality on Arterial Stiffness and Endothelial Function in Patients with Type 1 Diabetes and Kidney Disease: A Pilot Cross-Sectional Analysis

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Larson, Emily, University of Colorado Anschutz Medical Campus Department of Medicine, Aurora, Colorado, United States

Emily Larson, PhD

• Furgeson, Seth B., University of Colorado Anschutz Medical Campus Department of Medicine, Aurora, Colorado, United States

Seth B. Furgeson, MD

• Bjornstad, Petter, University of Washington School of Medicine, Seattle, Washington, United States

Petter Bjornstad, MD

• Moreau, Kerrie, University of Colorado Anschutz Medical Campus Department of Medicine, Aurora, Colorado, United States

Kerrie Moreau, PhD

• Kendrick, Jessica B., University of Colorado Anschutz Medical Campus Department of Medicine, Aurora, Colorado, United States

Jessica B. Kendrick, MD, MPH

Background

Diabetic kidney disease (DKD) markedly increases cardiovascular disease (CVD) risk and is a common complication of Type 1 diabetes (T1D). Vascular dysfunction, including large artery stiffening and endothelial dysfunction, contributes to CVD progression. Poor sleep quality is prevalent in T1D and DKD and is associated with accelerated kidney function decline, yet its impact on vascular function remains unknown. We hypothesized that individuals with T1D, DKD, and poor sleep (PS) quality would exhibit greater arterial stiffening and impairments in endothelial function compared to those reporting good sleep (GS).

Methods

Participants with T1D for ≥5 years and DKD (n=30, urine albumin:creatinine ratio [UACR] 30–5000 mg/g and/or estimated glomerular filtration rate [eGFR] <75 ml/min/1.73 m²) were enrolled. Arterial stiffness (carotid-femoral pulse wave velocity, PWV), endothelial function (brachial artery flow-mediated dilation, FMD), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were assessed. Participants were categorized as good sleepers (GS; PSQI < 6, n=18) or poor sleepers (PS; PSQI ≥ 6, n=12). Depression (PHQ-9) and anxiety severity (GAD-7) were also assessed. Data are mean and 95% confidence intervals. Group differences were examined using unpaired t tests or Mann-Whitney U tests; multiple linear regression was used to adjust for covariates.

Results

Groups did not differ in age, BMI, systolic or diastolic blood pressure, UACR, eGFR, anxiety severity, or PWV (PS: 8.7[7.4,9.9] vs GS: 9.0[8.0,10.1] m/s) (all P>0.2). PS had lower FMD (1.6[0.8,2.3] vs 2.7[1.9,3.5]%, P=0.049) and greater HbA1c (7.5[6.9,8.1] vs 6.9[6.7,7.2]%, P=0.033) and depression severity (4[1,8] vs 1[0,2] au, P=0.009) compared with GS, respectively. The FMD difference persisted after adjustment for depression severity (β=-1.6[-2.8,-0.4]%, P=0.011), but was attenuated after adjustment for HbA1c (P=0.059) and obstructive sleep apnea (OSA) history (P=0.057).

Conclusion

Poor sleep in T1D and DKD was associated with worse endothelial function, independent of depression severity. This association was attenuated after adjusting for HbA1c and OSA history, which may reflect limited statistical power of this pilot analysis. As sleep is a modifiable risk factor, future studies should examine the independent effect of poor sleep on vascular health in DKD.

Acknowledgment

JDRF 3-SRA-2022-1243-M-B
NIH TL1 DK147566-01
Ludeman Family Center for Women's Health Research
NIH/NCATS Colorado CTSA UM1 TR004399

Funding

• NIDDK Support