Association of symptoms of insomnia and sleep parameters among kidney transplant recipients

• Published in: Journal of psychosomatic research 2017-08, Vol.99, p.95-104
• Main Authors: Ronai, Katalin Z, Szentkiralyi, Andras, Lazar, Alpar S, Lazar, Zsolt I, Papp, Istvan, Gombos, Ferenc, Zoller, Rezso, Czira, Maria E, Lindner, Anett V, Mucsi, Istvan, Bodizs, Robert, Molnar, Miklos Z, Novak, Marta
• Format: Article
• Language: English
• Subjects: Beta activity; Complaints; Electroencephalography; Fatigue; Female; Humans; Insomnia; Kidney transplant recipients; Kidney transplantation; Kidney Transplantation - adverse effects; Kidney Transplantation - psychology; Kidney transplants; Latency; Male; Mental depression; Middle Aged; Morbidity; NREM sleep; Polysomnography; Polysomnography - methods; Power; Psychiatry; Quality of life; Quality of Life - psychology; REM sleep; Severity; Sleep; Sleep and wakefulness; Sleep architecture; Sleep disorders; Sleep Initiation and Maintenance Disorders - etiology; Slow wave sleep; Transplants & implants
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2017.05.019

Abstract Objective Insomnia complaints are frequent among kidney transplant (kTx) recipients and are associated with fatigue, depression, lower quality of life and increased morbidity. However, it is not known if subjective insomnia symptoms are associated with objective parameters of sleep architecture. Thus, we analyze the association between sleep macrostructure and EEG activity versus insomnia symptoms among kTx recipients. Methods Participants (n1 = 100) were selected from prevalent adult transplant recipients (n0 = 1214) followed at a single institution. Insomnia symptoms were assessed by the Athens Insomnia Scale (AIS) and standard overnight polysomnography was performed. In a subgroup of patients (n2 = 56) sleep microstructure was also analyzed with power spectral analysis. Results In univariable analysis AIS score was not associated with sleep macrostructure parameters (sleep latency, total sleep time, slow wave sleep, wake after sleep onset), nor with NREM and REM beta or delta activity in sleep microstructure. In multivariable analysis after controlling for covariables AIS score was independently associated with the proportion of slow wave sleep (β = 0.263; CI: 0.026–0.500) and REM beta activity (β = 0.323; CI = 0.041–0.606) ( p < 0.05 for both associations). Conclusions Among kTx recipients the severity of insomnia symptoms is independently associated with higher proportion of slow wave sleep and increased beta activity during REM sleep but not with other parameters sleep architecture. The results suggest a potential compensatory sleep protective mechanism and a sign of REM sleep instability associated with insomnia symptoms among this population.