Validation of a Single Item to Assess Daytime Sleepiness for the Swiss Transplant Cohort Study

Burkhalter, Hanna; Wirz‐Justice, Anna; Cajochen, Christian; Weaver, Terri E.; Steiger, Jürg; Fehr, Thomas; Venzin, Reto; Geest, Sabina De

doi:10.7182/pit2013788

Cited by 19 publications

(15 citation statements)

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“…Given that some studies have shown poor correlation of sleepiness assessed with different measurement tools and poor agreement between subjective and objective measures of sleepiness [33], the use of a single question to measure daytime sleepiness could have led to measurement error that could have tempered a potential association. However, single-item measures of sleepiness have also been shown to serve as effective screening tools [34,35]. Third, we had limited power to observe significant associations due to low case counts, particularly for stroke, which had only 18 cases for women who reported experiencing daytime sleepiness almost every day.…”

Section: Discussionmentioning

confidence: 98%

Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses’ Health Study II

et al. 2014

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Objective The objective of this study was to determine whether daytime sleepiness is independently associated with coronary heart disease (CHD) and stroke or whether the positive association is explained by short sleep duration, disturbed sleep, and circadian disruption, conditions that are associated with cardiometabolic risk factors for vascular events. Methods Longitudinal analyses of data from the Nurses’ Health Study II comprising 84,003 female registered nurses aged 37–54 at baseline were conducted in 2001 with follow-up until 2009. Multivariate Cox regression was used to explore the relationship between reported daytime sleepiness and the incidence of either CHD or stroke (n = 500 cases). Results Women who reported daytime sleepiness almost every day, compared with rarely/never, had an elevated adjusted risk of cardiovascular disease (CVD) (hazard ratio (HR) = 1.58, 95% confidence interval (CI) 1.15–2.17). Controlling for sleep variables (sleep duration, snoring, shift work, and sleep adequacy) or potential metabolic biological mediators of disrupted sleep (diabetes, hypercholesterolemia, and hyper-tension) appreciably attenuated the relationship (HR = 1.17, 95% CI 0.84–1.65; and HR = 1.34, 95% CI 0.97–1.85, respectively). Controlling for both sleep variables and metabolic risk factors eliminated an independent association (HR = 1.09, 95% CI 0.77–1.53). A similar pattern was observed for CHD and stroke individually. Conclusions Daytime sleepiness was not an independent risk factor for CVD in this cohort of women, but rather, was associated with sleep characteristics and metabolic abnormalities that are risk factors for CVD.

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Section: Discussionmentioning

confidence: 98%

Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses’ Health Study II

et al. 2014

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“…The stage sampling approach used was based on candidates’ PSQI and ESS scores, both of which were assessed as a part of the larger study [8]. The PSQI is a self-rated questionnaire consisting of 19 items, assessing a wide variety of factors related to sleep quality over a 1 month period, including estimates of sleep duration and latency, and of the frequency and severity of specific sleep-related problems.…”

Section: Methodsmentioning

confidence: 99%

“…Patients were informed at the start of the research project [8] that they might be invited for a further screening and assessment if their initial data indicated poor SQ and/or DS (see flowchart, Figure 1). Each such patient received a package containing an information letter, informed consent documents, a pre-stamped return envelope and the Survey of Sleep questionnaire (SOS).…”

Section: Methodsmentioning

confidence: 99%

“…As measured using the Epworth Sleepiness Scale (ESS), [8] data from three Swiss transplant centers showed a prevalence of 52% for poor SQ [8] and 50.9% for daytime sleepiness (DS). Most cross-sectional studies suggest that poor SQ is higher pre-RTx (49%-78% [3,9,10]) than post-RTx (30%-52% [1,11]).…”

Section: Introductionmentioning

confidence: 99%

“…In summary, sleep quality normally improves after RTx; [3] however, a high proportion of the current study’s RTx recipients were still suffering from sleep disorders several years post-Tx [8]. Prior to this study, no self-reported data existed on sleep disturbances among (post-Tx) RTx recipients.…”

Section: Introductionmentioning

confidence: 99%

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Self-reported sleep disturbances in renal transplant recipients

et al. 2013

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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.

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The Swiss Transplant Cohort Study: Lessons from the First 6 Years

Berger

Bochud

Boggian

et al. 2015

Curr Infect Dis Rep

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Prospective cohort studies significantly contribute to answering specific research questions in a defined population. Since 2008, the Swiss Transplant Cohort Study (STCS) systematically enrolled >95 % of all transplant recipients in Switzerland, collecting predefined data at determined time points. Designed as an open cohort, the STCS has included >3900 patients to date, with a median follow-up of 2.96 years (IQR 1.44-4.73). This review highlights some relevant findings in the field of transplant-associated infections gained by the STCS so far. Three key general aspects have crystallized: (i) Well-run cohort studies are a powerful tool to conduct genetic studies, which are crucially dependent on a meticulously described phenotype. (ii) Long-term real-life observations are adding a distinct layer of information that cannot be obtained during randomized studies. (iii) The systemic collection of data, close interdisciplinary collaboration, and continuous analysis of some key outcome data such as infectious diseases endpoints can improve patient care.

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Validation of a Single Item to Assess Daytime Sleepiness for the Swiss Transplant Cohort Study

Abstract: The accumulated evidence provided evidence for the validity of the STCS daytime sleepiness item as a simple screening scale for daytime sleepiness.

Cited by 19 publications

References 43 publications

Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses’ Health Study II

Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses’ Health Study II

Self-reported sleep disturbances in renal transplant recipients

The Swiss Transplant Cohort Study: Lessons from the First 6 Years

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