Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

PLoS One. 2017 Oct 11;12(10):e0185036. doi: 10.1371/journal.pone.0185036. eCollection 2017.

Abstract

Background: Poor sleep quality (SQ) is common after solid organ transplantation; however, very little is known about its natural history. We assessed the changes in SQ from pre- to 3 years post-transplant in adult heart, kidney, liver and lung recipients included in the prospective nation-wide Swiss Transplant Cohort Study. We explored associations with selected variables in patients suffering persistent poor SQ compared to those with good or variable SQ.

Methods: Adult single organ transplant recipients enrolled in the Swiss Transplant Cohort Study with pre-transplant and at least 3 post-transplant SQ assessment data were included. SQ was self-reported pre-transplant (at listing), then at 6, 12, 24 and 36 months post-transplant. A single SQ item was used to identify poor (0-5) and good sleepers (6-10). Between organ groups, SQ was compared via logistic regression analysis with generalized estimating equations. Within the group reporting persistently poor SQ, we used logistic regression or Kaplan-Meier analysis as appropriate to check for differences in global quality of life and survival.

Results: In a sample of 1173 transplant patients (age: 52.1±13.2 years; 65% males; 66% kidney, 17% liver, 10% lung, 7% heart) transplanted between 2008 and 2012, pre- transplant poor SQ was highest in liver (50%) and heart (49%) recipients. Overall, poor SQ decreased significantly from pre-transplant (38%) to 24 months post-transplant (26%) and remained stable at 3 years (29%). Patients reporting persistently poor SQ had significantly more depressive symptomatology and lower global quality of life.

Conclusion: Because self-reported poor SQ is related to poorer global quality of life, these results emphasize the need for further studies to find suitable treatment options for poor SQ in transplant recipients.

MeSH terms

  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Sleep / physiology*
  • Survival Analysis
  • Switzerland
  • Time Factors
  • Transplantation*

Grant support

The Swiss Transplant Cohort Study is funded by a grant from the Swiss National Research Foundation (Grant number 3347CO-108795). This work is further supported by unrestricted research grants of Astellas (CH & Europe), Roche (CH) and Novartis (CH). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.