A preliminary investigation of sleep quality and patient‐reported outcomes in pediatric solid organ transplant candidates

Gutierrez‐Colina, Ana M.; Cushman, Grace K.; Eaton, Cyd K.; Quast, Lauren F; Lee, Jennifer L.; Rich, Kristin Loiselle; Reed-Knight, Bonney; Mee, Laura; Romero, René; Mao, Chad; George, Roshan; Blount, Ronald L.

doi:10.1111/petr.13348

Cited by 5 publications

(9 citation statements)

References 28 publications

(51 reference statements)

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“…Overall, adolescent transplant recipients would likely benefit from psychoeducation about sleep hygiene, anticipatory guidance about how the transition to young adulthood can impact sleep, information about the potential sleep‐related side effects of their medication regimen, and ongoing clinical assessment of the contributors to sleep‐related symptomology. Further, given the link between sleep difficulties and barriers related to self‐management in adolescent patients awaiting transplantation, healthcare providers may gain valuable clinical insight by evaluating if and how sleep difficulties are negatively impacting adherence and self‐management in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…Changes in social and cultural norms, such as increased technology/social media use or increased homework demands after school, are likely responsible, at least in part, for the steady decline in children's total sleep duration over the past few decades . Comorbid sleep difficulties are even more prevalent among youth with special medical needs, with approximately 25% of liver transplant pediatric patients exhibiting clinically significant sleep problems . From a cumulative risk perspective, the confluence of general vulnerabilities for poor sleep among teens, along with medical and illness management factors salient to pediatric/transplant populations (eg, medication timing, immunosuppressive therapy, weight‐related factors, suboptimal sleep hygiene, mood disturbances, and comorbid diseases affecting sleep such diabetes or sleep disorders) is likely responsible for the higher rates of sleep difficulties observed among liver transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

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Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

Gutierrez‐Colina

Quast

Eaton

et al. 2019

Pediatric Transplantation

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This study examined patient‐reported sleep quality in a single‐center cross‐sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty‐nine adolescents (M = 16.51 years; SD = 1.63) who received a solid organ transplant (kidney: n = 25; liver: n = 24; heart: n = 20) completed self‐report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t = −3.60; P ≤ .001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r = −.31 to −.40), and higher physical and psychosocial HRQOL (r = .33‐.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non‐Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

Gutierrez‐Colina

Quast

Eaton

et al. 2019

Pediatric Transplantation

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“…To emphasize the additional impact of SDB on CV complications, studies confirmed twice as high estimated 10‐year stroke and coronary heart disease risk in RTx patients with SDB compared to those without SDB . Furthermore, poor sleep quality as a consequence is a possible barrier to medication regimen adherence . The beneficial effect of RTx on the severity of SDB remains controversial, and two out of three longitudinal studies reported no significant resolution of SDB after transplantation in adults …”

Section: Introductionmentioning

confidence: 99%

“…12 Furthermore, poor sleep quality as a consequence is a possible barrier to medication regimen adherence. 13 The beneficial effect of RTx on the severity of SDB remains controversial, and two out of three longitudinal studies reported no significant resolution of SDB after transplantation in adults. 14,15 Although studies carried out in the adult setting advocate for the high prevalence and the clinical importance of SDB in renal transplant patients, the condition in pediatric population has not been well described.…”

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confidence: 99%

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Cardiometabolic correlates of sleep‐disordered breathing in renal transplant children

Lendvai

Pásti

Szeifert

et al. 2019

Pediatric Transplantation

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Sleep‐disordered breathing, a prevalent condition among adult renal transplant (RTx) recipients, has become an established independent risk factor of MetS, and furthermore, it might contribute to increased CV risk. Despite the proven correlations in adults, there is a lack of evidence for its significance in the pediatric RTx population. In this study, we aimed at assessing the prevalence and the clinical correlates of SDB in RTx children. Data of 13 patients (age [mean ± SD]: 14.2 ± 2.7 years) were analyzed. SDB was evaluated by PSG, as severity score OAHI was applied. Carbohydrate metabolism was characterized by OGTT, whereas CV status was studied by ABPM. Three composite end‐points were calculated as sum of z‐scores: daytime systolic and diastolic BP; nighttime systolic and diastolic BP; and glucose and insulin levels at 120 minutes. Eight patients (61.5%) were diagnosed with SDB of whom five patients (38.5%) had moderate or severe SDB. In linear regression analysis, OAHI during REM was associated with the CV variables (daytime BP P = 0.032, ß = 0.748; nighttime BP P = 0.041, ß = 0.715), and the correlations remained significant after adjustments for BMI. However, we did not confirm a significant association with the metabolic variables. The prevalence of SDB was high, and its severity during REM was a predictor of the BP suggesting that RTx children with SDB might be at risk of developing CV complications, especially HTN similarly to adults.

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Changes in sleep patterns in primary care workers during the first wave of the COVID-19 pandemic in 2022 in Shanghai: a cross-sectional study

Cao,

Li,

Yan

et al. 2024

Sci Rep

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The coronavirus disease (COVID-19) pandemic has significantly affected the sleep health of healthcare workers (HCWs); however, no studies have assessed this effect in primary HCWs. This cross-sectional, web-based study explored the prevalence and factors associated with sleep disorders among primary HCWs during the first COVID-19 outbreak in Shanghai from 12 July to 15 August 2022. Sociodemographic and work-related characteristics, various sleep dimensions, and exposure to patients with COVID-19 were assessed. They were screened for common mental disorders (depression, burnout, and stress). Overall, 313 primary HCWs were recruited. At least one sleep dimension in 84% of respondents deteriorated compared with that observed pre-pandemic; sleep quality (decline of 66%) and daytime sleepiness (increase of 56%) were the most affected domains. After excluding 145 primary HCWs with pre-pandemic ‘poor sleep’, depression (odds ratio [OR] 3.08; 95% confidence interval [CI] 1.59–5.98), weekly burnout symptoms (OR 2.57; 95% CI 1.32–5.03), and high psychological stress (OR 4.51; 95% CI 2.09–9.72) were associated with poor sleep patterns during the pandemic. After adjusting for significant differences between groups, for every 1-point increase in the Perceived Stress Scale score, an associated 12% increased risk of poor sleep (adjusted OR 1.12; 95% CI 1.05–1.21; p = 0.002) was observed. Most primary HCWs showed significant worsening of sleep quality, with increases in daytime sleepiness during the first wave of the COVID-19 pandemic in Shanghai. HCWs with high stress levels were at greater risks of sleep disorders.

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A preliminary investigation of sleep quality and patient‐reported outcomes in pediatric solid organ transplant candidates

Cited by 5 publications

References 28 publications

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

Cardiometabolic correlates of sleep‐disordered breathing in renal transplant children

Changes in sleep patterns in primary care workers during the first wave of the COVID-19 pandemic in 2022 in Shanghai: a cross-sectional study

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