Self-reported sleep disturbances in renal transplant recipients

Abstract

BackgroundPoor sleep quality (SQ) and daytime sleepiness (DS) are common in renal transplant (RTx) recipients; however, related data are rare. This study describes the prevalence and frequency of self-reported sleep disturbances in RTx recipients.MethodsThis cross-sectional study included 249 RTx recipients transplanted at three Swiss transplant centers. All had reported poor SQ and / or DS in a previous study. With the Survey of Sleep (SOS) self-report questionnaire, we screened for sleep and health habits, sleep history, main sleep problems and sleep-related disturbances. To determine a basis for preliminary sleep diagnoses according to the International Classification of Sleep Disorders (ICSD), 164 subjects were interviewed (48 in person, 116 via telephone and 85 refused). Descriptive statistics were used to analyze the data and to determine the frequencies and prevalences of specific sleep disorders.ResultsThe sample had a mean age of 59.1 ± 11.6 years (60.2% male); mean time since Tx was 11.1 ± 7.0 years. The most frequent sleep problem was difficulty staying asleep (49.4%), followed by problems falling asleep (32.1%). The most prevalent sleep disturbance was the need to urinate (62.9%), and 27% reported reduced daytime functionality. Interview data showed that most suffered from the first ICSD category: insomnias.ConclusionThough often disregarded in RTx recipients, sleep is an essential factor of wellbeing. Our findings show high prevalences and incidences of insomnias, with negative impacts on daytime functionality. This indicates a need for further research on the clinical consequences of sleep disturbances and the benefits of insomnia treatment in RTx recipients.

Melatonin rhythms in renal transplant recipients with sleep–wake disturbances

“…This study originally investigated 926 RTx recipients (Burkhalter et al, 2014), of whom 21.3% reported daytime sleepiness (ESS > 10) and 58.6% reported poor sleep quality (PSQI > 5); 249 RTx recipients participated in a sleep survey and 164 RTx participated in the subsequent sleep assessment to determine a preliminary sleep disorders diagnosis (Burkhalter et al, 2013); 49 had a putative diagnosis of SWD, of whom 30 participated in the bright light intervention study (Burkhalter et al, 2015). Within this latter group a high majority had low or no melatonin rhythm.…”

“…Participants were recruited at the University Hospitals of Basel, Berne and Zurich and had all participated in a screening study to evaluate sleep disorders in these patients (Burkhalter et al, 2013;Burkhalter et al, 2014). The inclusion criteria were adult RTx recipients more than 1 year post-transplant and diagnosed with SWD (sleep assessment interview in the preceding study); German speaking; on stable immunosuppressive drugs and no signs of acute rejection.…”

“…Baseline conditions were the same for the intervention and the control groups. (Antonovsky, 1993)), physical activity (Godin Leisure-Time Exercise Questionnaire: GLTEQ (Godin & Shephard, 1985)), chronotype (Morningness-Eveningness Questionnaire) and the sleep measurements (assessment questionnaire) were retrieved from our previous observational study data bank (Burkhalter et al, 2011;Burkhalter et al, 2013;Burkhalter et al, 2014). A high sense of coherence reflects an attitude of confidence that life events (e.g.…”

“…Instead, routine assessment of selfreported sleep quality and daytime sleepiness should be performed regularly with a simple visual analogue scale (Burkhalter et al, 2011). The detection of poor sleep quality and/or excessive daytime sleepiness should prompt a sleep assessment (Burkhalter et al, 2013) with a sleep diary or an actimeter (objective data). Thereafter, sleep hygiene rules should be encouraged, including regular sleep-wake schedules, exposure to bright light in the early hours of the morning (e.g.…”

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

“…14, 15 Earlier we reported that chronic insomnia was independently associated with the presence of depression in kTx recipients. 16 In the general population there is a strong and bidirectional relationship between depression and sleep.…”