Association between sleep duration and kidney stones in 34 190 American adults: A cross-sectional analysis of NHANES 2007-2018

Association between life's crucial 9 and kidney stones: a population-based study

Purpose

This study examined the association between the Life's Crucial 9 (LC9) score and kidney stone prevalence in U.S. adults.

Methods

Using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2014, this cross-sectional analysis focused on adult participants with kidney stone onset or recurrence. LC9 scores were divided into four quartiles for analysis. Weighted multivariable logistic regression, restricted cubic spline (RCS) modeling, threshold effect analysis, and subgroup analyses were employed to evaluate the relationship between LC9 scores and kidney stone prevalence.

Results

The study included 24,669 participants with an average age of 46.05 ± 0.34 years and a mean LC9 score of 73.76 ± 0.25. The overall prevalence of kidney stones was 8.45%, while the average recurrence rate stood at 2.96%. Importantly, for each one-point increase in the LC9 score, the incidence of kidney stones dropped by 1.2% (95% CI: 0.979 to 0.997, p = 0.014). Compared to the lowest quartile (Q1), the Q4 group exhibited a 0.305-fold higher recurrence rate (95% CI: 0.159 to 0.586, p < 0.001). Interaction analysis showed that race and gout significantly influenced the relationship between the LC9 score and kidney stone risk. Additionally, curve fitting and threshold effect analysis demonstrated a nonlinear association between LC9 scores and kidney stone recurrence, with a breakpoint identified at 72.777.

Conclusion

An elevated LC9 score correlates with a lower risk of both kidney stone formation and recurrence. Maintaining an optimal LC9 score could be an effective approach for preventing kidney stones.

Association between Two Cardiovascular Health Algorithms and Kidney Stones: A Nationwide Cross-sectional Study

Background and objective

There is limited literature on the relationship between cardiovascular health (CVH) and kidney stones. This study aims to compare the association of Life's Simple 7 (LS7) and Life's Essential 8 (LE8) with kidney stone prevalence.

Methods

A cross-sectional analysis was conducted utilizing NHANES data (2007-2018). Participants aged ≥20 yr with a history of kidney stones and available LS7 and LE8 scores were included. Both LS7 and LE8 are scored such that higher scores indicate better CVH. Weighted proportions and multivariable logistic regression models assessed the relationship between CVH metrics and kidney stone prevalence, adjusting for confounders. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were determined to distinguish between LS7 and LE8 in terms of their discriminative ability within the model associated with kidney stones.

Key findings and limitations

A total of 23 563 adults were included; the mean age was 48.1 yr (48.1% male). Kidney stone prevalence was 10.1%. The mean LS7 and LE8 scores were 8.4 and 68.6, respectively. A multivariate analysis and the restricted cubic spline model indicated a significant nonlinear negative correlation between these CVH measures and kidney stone prevalence. The LS7 ideal group showed a lower prevalence than the poor group (odds ratio [OR] = 0.53; 95% confidence interval [CI] 0.41-0.69). The high CVH group had a lower prevalence than the low CVH group (OR = 0.46; 95% CI 0.36-0.57). The AUCs for evaluating LS7 and kidney stones, as well as for LE8 and kidney stones were 0.676 and 0.677, respectively. Limitations were as follows: cross-sectional design limiting causal inference, recall bias from self-reported data, and potential residual confounding.

Conclusions and clinical implications

Both CVH algorithms show a significant nonlinear negative correlation with kidney stone prevalence. LS7 may be more accessible for broader implementation. Further high-quality prospective studies are needed to clarify this relationship.

Patient summary

In this study, we explored the connection between heart health and kidney stones using data from a large national survey. We found that better heart health, measured by two different scoring methods, is linked to a lower chance of having kidney stones. Our results suggest that promoting heart health could help reduce the risk of kidney stones in adults.

Adherence to a healthy sleep pattern and the risk of kidney stone disease: A prospective study of UK biobank

PURPOSE

This research seeks to assess the connection between healthy sleep patterns and the occurrence of kidney stone disease (KSD) by analyzing data obtained from a large-scale cohort study.

METHODS

We examined 313,870 initial participants without KSD from the UK Biobank. Five healthy sleep factors were assessed: no frequent excessive daytime sleepiness, early chronotype, no snoring, sleeping 7-8 h daily, and never or rarely experiencing insomnia at baseline. A healthy sleep score between 0 and 5 was assigned to participants according to these criteria. We utilized Cox proportional hazards models to calculate hazard ratios (HR) and 95 % confidence intervals (CI) between a healthy sleep score and the occurrence of KSD.

RESULTS

During the follow-up period, 3818 new cases of KSD were recorded. After comprehensive adjustments, every 1-point rise in the healthy sleep score was associated with an HR of 0.93 (95 % CI: 0.90-0.96). Additionally, individuals with a healthy sleep score of 5 had a 20 % lower risk of KSD compared to those with scores between 0 and 2.

CONCLUSIONS

Our study results indicate that adhering to a healthy sleep pattern can reduce the risk of KSD.

Life's Essential 8 and kidney stones in US adults: mediating roles of HDL and insulin resistance

BACKGROUND

The rising incidence of kidney stones underscores the imperative to devise effective preventive measures. While a robust association between cardiovascular disease (CVD) and kidney stones exists, the current research landscape lacks investigations between cardiovascular health (CVH) and kidney stones. This study aims to explore the association between CVH, assessed by Life's Essential 8 (LE8), and kidney stones, with the role of blood lipids and insulin resistance in this relationship.

METHODS

The study included 19,942 adults aged ≥20 from the National Health and Nutrition Examination Survey of the US from 2007 to 2018. LE8, measuring CVH, includes four behavior and four factor metrics. Participants were categorized into high, moderate, and low CVH levels according to LE8 Scores: 80-100, 50-79, and 0-49, respectively. Kidney stones cases were identified through interviews and self-reported records. Weighted multivariate linear regressions, weighted logistic regressions, restricted cubic spline (RCS) analysis, mediation analyses, and sensitivity analyses were conducted.

RESULTS

In the fully adjusted logistic model, 10-point increase in LE8 Score exhibited a significant 19% reduction in kidney stones prevalence (OR=0.81, 95% CI: 0.77-0.85). The RCS confirmed the nonlinear association between LE8 Score and kidney stones (P for non-linearity: 0.004). Mediation analyses showed the mediation proportions of 19.62%, 24.26%, and 27.82% for high-density lipoprotein (HDL), insulin resistance (HOMA-IR), and serum insulin, respectively. The mediation proportions of the HOMA-IR-HDL and serum insulin-HDL pathways were 6.62% and 5.96%, respectively.

CONCLUSIONS

This study illuminates a negative association between CVH and kidney stones, providing an effective strategy for kidney stones prevention.

Association between sleep patterns and depression in older adults: a cross-sectional study using data from the National Health and Nutrition Examination Survey 2007-2014

OBJECTIVE

To assess the association between sleep patterns and sleep factors (sleep duration, trouble sleeping, sleep disorder) and the risk of depression in older adults.

METHODS

A total of 5636 participants (2754 men and 2882 women) aged 60 years and older from the 2007-2014 waves of the National Health and Nutrition Examination Survey (NHANES) were included. Sleep duration, sleep problems, and sleep disorders were assessed in the home by trained interviewers using the Computer-Assisted Personal Interviewing (CAPI) system. The combined sleep behaviours were referred to as 'sleep patterns (healthy, intermediate and poor)', with a 'healthy sleep pattern' defined as sleeping 7-9 h per night with no self-reported trouble sleeping or sleep disorders. Intermediate and poor sleep patterns indicated 1 and 2-3 sleep problems, respectively. Baseline characteristics of participants analysed using one-way logistic regression. Logistic multiple linear regression was used to assess the association of sleep factors and sleep patterns with the risk of depressive symptoms.Conduct subgroup analyses to ensure robustness of findings.

RESULTS

The overall prevalence of depression was 7.7% among the 5636 participants analysed, with the rate of depression in older women being 1.6 times higher than in older men. The prevalence of depression was higher in older adults with intermediate sleep pattern than in older adults with healthy sleep pattern (OR: 2.28, 95% CI: 1.71-3.03, p < 0.001). The prevalence of depression was higher in older adults with poor sleep pattern than in older adults with healthy sleep pattern (OR: 5.60, 95% CI: 4.25-7.39, p < 0.001). The findings were robust after controlling for sleep items in the PHQ-9.

CONCLUSION

This nationally representative survey showed a relationship between sleep patterns and depression in older adults. However, the study population was limited to Americans, and we recommend continued investigation of the causal relationship and mechanisms between the two in the future, and further expansion of data sources in order to assess the applicability of the findings.

Genetic correlation and mendelian randomization reveal the impact of sleep traits on urolithiasis risk

Urolithiasis is a common and recurrent condition in the urological spectrum. Despite various proposed mechanisms, the causal relationship between sleep traits and the risk of urolithiasis remains unclear. We used publicly available genome-wide association study (GWAS) summary data from the UK Biobank and FinnGen to perform a two-sample Mendelian randomization (MR) analysis and genetic correlation analysis, evaluating the causal relationship and genetic correlation between sleep traits (chronotype, getting up in the morning, sleep duration, nap during the day, and insomnia) and urolithiasis (calculus of the kidney and ureter, and calculus of the lower urinary tract). Additionally, multivariable MR (MVMR) analysis adjusted for body mass index (BMI) and other sleep characteristics was conducted to assess the direct impact of sleep traits on the risk of urinary tract stones. The LD score regression (LDSC) analysis indicated a genetic correlation between insomnia and upper urinary tract stones (rg = 0.082, P = 0.017, Adjusted P = 0.085), but no significant genetic correlation was found for other sleep traits. Our results indicated no causal relationship between sleep traits and upper urinary tract stones. However, insomnia was significantly associated with a higher risk of lower urinary tract stones (IVW [inverse variance weighted] OR [odds ratio] = 5.91, 95% CI [confidence interval] 1.52-22.98, P = 0.010, Adjusted P = 0.030), while early rising exhibited a protective effect (IVW OR = 0.29, 95% CI 0.11-0.76, P = 0.012, Adjusted P = 0.030). In the MVMR analysis, insomnia consistently showed a similar trend, whereas daytime napping significantly reduced the risk of lower urinary tract stones (OR = 0.28, 95% CI 0.12-0.65, P = 0.003). This study provides MR-based evidence suggesting that insomnia may increase the risk of lower urinary tract stones, while daytime napping may reduce this risk. No causal relationship was found between sleep characteristics and upper urinary tract stones.

Self-Reported Symptoms of Obstructive Sleep Apnea are Associated with Increased Risk of Kidney Stones: A Cross-Sectional Study from NHANES 2015-2020

Objective

To investigate whether self-reported symptoms of obstructive sleep apnea (OSA), including snoring, snorting/stopping breathing, and sleepiness, are associated with increased risk of kidney stones.

Methods

This cross-sectional study was conducted based on the 2015-2020 National Health and Nutrition Examination Survey (NHANES). Self-reported symptoms of OSA and history of kidney stones were diagnosed via questionnaires. Multivariable logistic regression was used to determine the associations between self-reported symptoms of OSA and kidney stones. Subgroup analyses and interaction tests were performed to address this issue further.

Results

A total of 9,973 participants were enrolled, and the prevalence of kidney stones was 10.76%. Although no significant association was observed between frequent snoring and kidney stones after covariate adjustments (OR 1.033, 95% CI 0.726, 1.469 p = 0.850), frequent snorting/stopping breathing was associated with a greater risk of kidney stones after covariate adjustments (OR 1.655, 95% CI 1.262, 2.172, p = 0.002). Participants who often or almost always felt sleepy also had a greater risk of kidney stones after covariate adjustment (OR 1.651, 95% CI 1.222, 2.229; p = 0.004). The interaction tests suggested that marital status (p = 0.015) and smoking status (p < 0.001) significantly interacted with the association between snorting/stopping breathing and kidney stones.

Conclusion

Self-reported frequent snorting/stopping breathing and sleepiness may be associated with increased risk of kidney stones. Although these findings may emphasize prevention of kidney stones in these people, further research was still needed to verify our results.

Use of the flexible vacuum-assisted ureteral access sheath combined with flexible ureteroscope for patients with large renal stones

OBJECTIVE

To explore the effects and safety of the flexible vacuum-assisted ureteral access sheath combined with a flexible ureteroscope for the treatment of large renal stones over 3 cm.

METHODS

In this retrospective study, 122 patients with kidney stones (stone diameter ≥ 3 cm) admitted to our hospital from January 2018 to December 2022 were selected as the study subjects. According to different surgical methods, these patients were divided into an observation group and a control group, with 61 cases in each group. Patients in the control group were treated with the conventional negative pressure-assisted ureteral access sheath combined with flexible ureteroscope, while those in the observation group were treated with the flexible vacuum-assisted ureteral access sheath combined with flexible ureteroscope. The perioperative indexes, stone-free rate, usage rate of basket extraction, inflammation level, renal functional indexes, and incidence of postoperative complications were evaluated and compared between the two groups.

RESULTS

The extubation time, rate of multiple operations, and surgery cost in the observation group were significantly less than those of the control group (all P < 0.05), but the operation time was longer in the observation group than that of the control group (P < 0.05). The stone-free rate at 3 days after surgery in the observation group was higher than that of the control group, while the usage rate of basket extraction of the observation group was significantly less than that of the control group (all P < 0.05). The postoperative levels of C-reactive protein (CRP) and Interleukin (IL)-6 were significantly lower, while the level of IL-10 was significantly higher in the observation group than in the control group (all P < 0.001). The levels of renal functional indexes such as CysC, Scr, and KIM-1 in the observation group were lower than those of the control group (all P < 0.05). The total incidence of postoperative complications in the observation group was 8.20%, which was lower than 24.59% in the control group (P = 0.014). Moreover, postoperative sleep quality was better, and the comfort score was higher in the observation group than that of the control group (all P < 0.001).

CONCLUSION

The flexible vacuum-assisted ureteral access sheath combined with flexible ureteroscope is effective in the treatment of large renal stones over 3 cm, and may improve the perioperative indexes, postoperative sleep quality and comfort, increase the stone-free rate, alleviate the inflammation levels and kidney functional injury, and reduce the incidence of complications.

Association between weight-adjusted waist circumference index and depression in older patients with hypertension: a study based on NHANES 2007-2016

Objective

Our aim was to assess the relationship between weight-adjusted waist circumference index (WWI) and the prevalence of depression in older adult hypertensive patients in the United States.

Methods

We selected individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2016 and used logistic regression analyses, subgroup analyses, and dose-response curves to assess the associations between the WWI index and the prevalence of depression in older hypertensive patients with age, sex, and BMI.

Results

A total of 4,228 participants aged ≥60 years with hypertension were included in our study; 364 patients were assessed for depression. After correction for confounders, each unit increase in WWI increased the risk of depression in older hypertensive patients by 19% (OR = 1.19, 95% CI: 0.99, 1.43). Dose-response curves showed that the WWI index was positively associated with the prevalence of depression in older hypertensive patients when the WWI index was ≥11.6. Based on subgroup analyses, this association was particularly pronounced in individuals ≥70 years of age, women, and individuals with a BMI of 25 or greater.

Conclusion

Higher WWI scores were positively associated with the prevalence of depression in older hypertensive patients and correlated with gender, age and BMI. This is notable, although a causal relationship cannot be established at this time.

Association between kidney stones and poor sleep factors in U.S. adults

The purpose of our study is to examine the correlation between sleep factors and the prevalence of kidney stones in US adults. A total of 34,679 participants from the National Health and Nutrition Examination Survey 2007 to 2018 were included in the analyses. Sleep data collection included: presleep factors (difficulty falling asleep, sleep onset latency), intra-sleep factors (risk index of obstructive sleep apnea, restless leg syndrome, difficulty maintaining sleep), post-sleep factors (daytime sleepiness, non-restorative sleep), sleep schedule and duration, and sleep quality. Logistic regression models were used to analyze the correlation between sleep factors and the prevalence of kidney stones. Among the 34,679 participants, the overall incidence of kidney stones was 9.3%. The presence of presleep factors (difficulty falling asleep [odds ratios [OR], 1.680; 95% CI, 1.310-2.150], prolonged sleep onset latency [OR, 1.320; 95% CI, 1.020-1.700]), intra-sleep factors (higher risk index of obstructive sleep apnea [OR, 1.750; 95% CI, 1.500-2.050], restless leg syndrome [OR, 1.520; 95% CI, 1.150-1.990], difficulty maintaining sleep [OR, 1.430; 95% CI, 1.130-1.810]), post-sleep factors (daytime sleepiness [OR, 1.430; 95% CI, 1.220-1.680], non-restorative sleep [OR, 1.400; 95% CI, 1.110-1.760]), short sleep duration (OR, 1.190; 95% CI, 1.080-1.310), mediate sleep quality (OR, 1.140; 95% CI, 1.020-1.290), and poor sleep quality (OR, 1.500; 95% CI, 1.310-1.720) are linked to the occurrence of kidney stones. However, short sleep onset latency, bedtime and wake-up time were not significantly associated with the prevalence of kidney stones. These findings showed positive associations between higher kidney stone prevalence and poor sleep factors.

Association between kidney stones and life's essential 8: a population-based study

BACKGROUND

Kidney stones exhibit a robust correlation with cardiovascular disease (CVD). The objective of this research is to investigate the correlation between kidney stones and Life's Essential 8 (LE8), a newly updated assessment of cardiovascular health (CVH), among adults in the United States.

METHODS

In this study, which analyzed data from the 2007-2018 National Health and Nutrition Examination Survey, we employed LE8 scores (ranging from 0 to 100) as the independent variable, classifying them into low, moderate, and high CVH categories. The research examined the relationship between LE8 scores and kidney stones by using multivariate logistic regression and restricted cubic spline models, with kidney stones as the dependent variable.

RESULTS

Out of the 14,117 participants in this research, the weighted mean LE8 score was 69.70 ± 0.27. After accounting for confounding factors, there was an inverse association between higher LE8 scores and the likelihood of developing kidney stones (OR of 0.81 per 10-point increase, with a 95% confidence interval of 0.77-0.85), demonstrating a non-linear dose-response pattern. Similar patterns were observed for health behaviors, health factor scores, and kidney stones. Stratified analyses demonstrated a stable negative correlation between LE8 scores and kidney stones across different subgroups.

CONCLUSION

LE8 and its subscale scores exhibited a robust and inverse correlation with the occurrence of kidney stones. Encouraging adherence to optimal CVH levels has the potential to serve as an effective strategy in preventing and minimizing the occurrence of kidney stones.

Association between the American Heart Association's new "Life's Essential 8" metrics and kidney stone

PURPOSE

The incidence of kidney stone disease has increased worldwide, resulting in high medical costs and social burden. Kidney stone disease shares some common features with the risk factors of cardiovascular diseases (CVDs). We investigated the association between cardiovascular health (CVH) based on the Life's Essential 8 (LE8) score developed by the American Heart Association and the incidence of kidney stone disease.

METHODS

We analyzed the data of 29,469 US adults aged 20 years or above from the National Health and Nutrition Examination Survey, 2007-2018. According to the LE8 score, CVH was divided into three categories: poor, intermediate, and ideal. Logistic regression was used to determine the association between CVH and the incidence of kidney stone disease by estimating odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

The average age of the participants was 48.6 years, and 50% of the participants were women. The numbers of participants with poor, intermediate, and ideal CVH were 4149, 19,782, and 5538, respectively. After adjusting for related confounding factors, ideal CVH was associated with a reduction in the odds of kidney stone occurrence as compared to poor CVH (adjusted OR [aOR]: 0.45, 95% CI: 0.35-0.57, p < 0.001). Moreover, if the ideal CVH metrics was ≥ 6, the odds of kidney stone occurrence decreased by up to 61% (aOR: 0.39, 95% CI: 0.30-0.51).

CONCLUSIONS

In the present study, ideal CVH, a factor indicative of a healthy lifestyle, was associated with lower odds of kidney stone occurrence.

Sleep and circadian rhythm disturbance in kidney stone disease: a narrative review

The circadian rhythm generated by circadian clock genes functions as an internal timing system. Since the circadian rhythm controls abundant physiological processes, the circadian rhythm evolved in organisms is salient for adaptation to environmental change. A disturbed circadian rhythm is a trigger for numerous pathological events. Recently, accumulated data have indicated that kidney stone disease (KSD) is related to circadian rhythm disturbance. However, the mechanism between them has not been fully elucidated. In this narrative review, we summarized existing evidence to illustrate the possible association between circadian rhythm disturbance and KSD based on the epidemiological studies and risk factors that are linked to circadian rhythm disturbance and discuss some chronotherapies for KSD. In summary, KSD is associated with systemic disorders. Metabolic syndrome, inflammatory bowel disease, and microbiome dysbiosis are the major risk factors supported by sufficient data to cause KSD in patients with circadian rhythm disturbance, while others including hypertension, vitamin D deficiency, parathyroid gland dysfunction, and renal tubular damage/dysfunction need further investigation. Then, some chronotherapies for KSD were confirmed to be effective, but the molecular mechanism is still unclear.

Lifestyle factors, serum parameters, metabolic comorbidities, and the risk of kidney stones: a Mendelian randomization study

Background and objective

The early identification of modifiable risk factors is important for preventing kidney stones but determining causal associations can be difficult with epidemiological data. We aimed to genetically assess the causality between modifiable factors (lifestyle factors, serum parameters, and metabolic comorbidities) and the risk of kidney stones. Additionally, we aimed to explore the causal impact of education on kidney stones and its potential mediating pathways.

Methods

We conducted a two-sample Mendelian randomization (MR) study to explore the causal association between 44 modifiable risk factors and kidney stones. The FinnGen dataset initially explored the causal relationship of risk factors with kidney stones and the UK Biobank dataset was used as the validation set. Then, a meta-analysis was conducted by combining discovery and validation datasets. We used two-step MR to assess potential mediators and their mediation proportions between education and kidney stones.

Results

The combined results indicated that previous exposures may increase the risk of kidney stones, including sedentary behavior, urinary sodium, the urinary sodium/potassium ratio, the urinary sodium/creatinine ratio, serum calcium, 25-hydroxyvitamin D (25OHD), the estimated creatinine-based glomerular filtration rate (eGFRcrea), GFR estimated by serum cystatin C (eGFRcys), body mass index (BMI), waist circumference, type 2 diabetes mellitus (T2DM), fasting insulin, glycated hemoglobin, and hypertension. Coffee intake, plasma caffeine levels, educational attainment, and the urinary potassium/creatinine ratio may decrease the risk of kidney stones. Ranked by mediation proportion, the effect of education on the risk of kidney stones was mediated by five modifiable risk factors, including sedentary behavior (mediation proportion, 25.7%), smoking initiation (10.2%), BMI (8.2%), T2DM (5.8%), and waist circumference (3.2%).

Conclusion

This study provides MR evidence supporting causal associations of many modifiable risk factors with kidney stones. Sedentary lifestyles, obesity, smoking, and T2DM are mediating factors in the causal relationship between educational attainment and kidney stones. Our results suggest more attention should be paid to these modifiable factors to prevent kidney stones.

Association between circadian syndrome and the prevalence of kidney stones in overweight adults: a cross-sectional analysis of NHANES 2007-2018

OBJECTIVE

To explore the association between circadian syndrome (CircS) and the prevalence of kidney stones in overweight people.

MATERIALS AND METHODS

A cross-sectional analysis was conducted based on the NHANES 2007-2018. Overweight people aged ≥ 20 years were the target population. Three multivariable logistic regression models were built to examine the association between CircS and kidney stones. Subgroup analysis based on age, gender, and race were also employed. Interaction and stratification analysis was also conducted to identify whether some factors modify the association.

RESULT

A total of 4,603 overweight participants were included in the study. The multivariable logistic regression suggested that CircS was positively associated with the prevalence of kidney stones (OR = 1.422, 95% CI 1.057 to 1.912). The subgroup analysis showed that the association was more obvious in females (OR = 1.604, 95% CI 1.023 to 2.516) or in the population aged 35 to 49 years old (OR = 2.739, 95% CI 1.428 to 5.254). Additionally, the same trend was present when people were Mexican American (OR = 3.834, 95% CI 1.790 to 8.215) or other races (OR = 4.925, 95% CI 1.776 to 13.656). The interaction and stratification analysis showed that the results above were robust.

CONCLUSION

CircS was positively associated with the prevalence of kidney stones in overweight people, especially people as females, aged 35 to 49, and Mexican Americans.

Chronic sleep loss sensitizes Drosophila melanogaster to nitrogen stress

Chronic sleep loss profoundly impacts metabolic health and shortens lifespan, but studies of the mechanisms involved have focused largely on acute sleep deprivation.1,2 To identify metabolic consequences of chronically reduced sleep, we conducted unbiased metabolomics on heads of three adult Drosophila short-sleeping mutants with very different mechanisms of sleep loss: fumin (fmn), redeye (rye), and sleepless (sss).3,4,5,6,7 Common features included elevated ornithine and polyamines, with lipid, acyl-carnitine, and TCA cycle changes suggesting mitochondrial dysfunction. Studies of excretion demonstrate inefficient nitrogen elimination in adult sleep mutants, likely contributing to their polyamine accumulation. Increasing levels of polyamines, particularly putrescine, promote sleep in control flies but poison sleep mutants. This parallels the broadly enhanced toxicity of high dietary nitrogen load from protein in chronically sleep-restricted Drosophila, including both sleep mutants and flies with hyper-activated wake-promoting neurons. Together, our results implicate nitrogen stress as a novel mechanism linking chronic sleep loss to adverse health outcomes-and perhaps for linking food and sleep homeostasis at the cellular level in healthy organisms.