What are the sleep characteristics among early kidney transplant recipients? An objective and subjective measurement from China

A Delayed Wake-Up Call: Is Perioperative Sleep Contributing to Delayed Graft Function?

Renal transplantation offers dialysis-dependent patients a new lease on life. Compared with chronic dialysis, kidney transplant recipients benefit from a substantially improved quality and quantity of life. Despite increases in age and comorbidity among contemporary transplant recipients, recipients can expect substantial decreases in all-cause mortality, hospitalizations from infections (despite the required immunosuppression), and cardiovascular events. Invariably, the benefits of transplantation require the ongoing survival and function of the graft. Long-term graft function and patient survival are correlated with graft function in the immediate postoperative period. However, in up to 30% of cases, a wide range of clinical factors contribute to insufficient graft function, requiring transplant recipients to undergo further dialysis in a complication referred to as delayed graft function. An intermediate phenotype, slow graft function, is characterized by slower postoperative declines in creatinine without the need for dialysis and is similarly associated with long-term graft failure. These postoperative complications also confer additional costs to the health care system, with more intensive and protracted hospital stays. Delayed graft function and slow graft function continue to be major obstacles in allograft and patient survival; however, a possible contributing factor that requires further attention is perioperative sleep.

Correlation of objective and subjective sleep parameters with fatigue and depression in kidney transplant recipients

OBJECTIVES

Sleep quality in kidney transplant recipients is closely associated with symptoms of fatigue and depression. Although subjective assessment tools like the Pittsburgh Sleep Quality Index and the Richards-Campbell Sleep Questionnaire (RCSQ) are widely used to evaluate sleep quality, there is a lack of studies utilizing polysomnography for objective evaluation. This study aims to investigate the correlation between sleep quality, fatigue, and depression in kidney transplant recipients using both subjective and objective methods, providing scientific evidence for improving their quality of life.

METHODS

The cross-sectional study conveniently sampled 50 kidney transplant recipients from a transplant center in a general hospital between August 2018 and March 2020. Subjective and objective sleep parameters were evaluated using the RCQS and polysomnography, respectively. The Fatigue Severity Scale was used to assess fatigue, and the Hamilton Depression Scale was employed to measure depression levels.

RESULTS

A lower proportion of rapid eye movement (REM) sleep was associated with increased fatigue. Additionally, higher wake time percentages and poorer sleep quality were significantly correlated with greater depression severity.

CONCLUSIONS

This study underscores the critical importance of effectively managing sleep quality in kidney transplant recipients and addressing their fatigue and depression symptoms. These findings lay a foundation for developing targeted nursing and therapeutic strategies.

Sleep Patterns in Patients After Solid Organ Transplantation Including Gender and Age Differences. Survey Results From One Transplantation Centre in Poland

INTRODUCTION

Sleep plays a crucial role in maintaining health. Transplant patients are exposed to numerous stressors and are at risk of sleep disturbances. The aim of this study was to assess the sleep patterns of transplant patients.

METHODS

An anonymous paper survey was carried out among patients from one transplant center in Poland. Respondents were asked about the quality and quantity of sleep and the overall impact of the transplantation on their night rest. Data were collected from June to November 2023.

RESULTS

Data were obtained from 212 respondents (122 males and 90 females), aged 48.38 ± 13.68. The positive impact of transplantation on sleep hygiene was indicated by 57.4% of respondents, 28.9% observed no impact, and 13.6% rated the impact as negative. Our study showed that sleep is more satisfying in males than in females (62.8% of males and 46.7% of females). The analysis revealed that 38.9% of females need 30 minutes more than men to fall asleep. Additionally, females tend to get up half an hour later compared to men. About 71.9% of males declared good well-being the next day compared to 62.2% of females. Furthermore females declared more sleepiness the next day. The study also showed that older transplant recipients (over 50 years-of-age) report more frequent awakenings at night.

CONCLUSIONS

The data collected showed differences in sleep patterns according to gender and age. Females and older patients should be screened for sleep disturbances during post-transplantation care.