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Sleep quality and its association with health-related quality of life of patients on lung transplantation waitlist in Japan

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Poor quality of sleep is a common feature in patients with various lung diseases and affects their health-related quality of life (HRQL). We evaluated sleep quality and HRQL in patients on the waitlist for lung transplantation in Japan.

Methods

In this prospective study, patient-reported and physiological data were collected from patients newly registered on the waitlist for lung transplantation in Japan. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and HRQL using the St. George’s Respiratory Questionnaire (SGRQ). The frequency of poor sleep quality, correlations between sleep quality and various clinical parameters, and predictive factors of sleep quality were examined.

Results

Of 193 patients, the three most-frequent indications for lung transplantation were interstitial pneumonia (n = 96), pulmonary complications of hematopoietic stem cell transplantation (n = 25), and pulmonary hypertension (n = 17). Poor sleep quality (PSQI > 5) was observed in 102 patients (53%) and was significantly associated with worse Hospital Anxiety and Depression Score (HADS), worse SGRQ score, worse modified Medical Research Council Dyspnea score, and shorter 6-min walk distance. However, it was not associated with sex, pulmonary function, interstitial pneumonia, or arterial blood gas. Stepwise multiple regression analysis indicated that poor sleep quality was explained significantly by HADS anxiety (23%) and SGRQ Symptoms (10%).

Conclusion

Poor sleep quality was found to be common among patients on the lung transplantation waitlist in Japan. The two most significant factors responsible for impaired sleep quality were anxiety and respiratory symptoms. Additional care should be taken to ensuring a better quality of sleep for such patients.

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Funding

This work was partly supported by a grant to the Respiratory Failure Research Group from the Ministry of Health, Labour and Welfare (no. 851160600002). The Department of Respiratory Care and Sleep Control Medicine, Kyoto University (KC) is funded by endowments from Philips-Respironics, Teijin Pharma, Resmed Japan, Fukuda Denshi, and Fukuda Lifetec Keiji to Kyoto University (no. 201070700002).

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junko Tokuno, Masaki Ikeda, Satona Tanaka, Yoshito Yamada, Yojiro Yutaka, Akihiro Ohsumi, Daisuke Nakajima, Masatsugu Hamaji, Maki Isomi & Hiroshi Date

  2. Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan

    Toru Oga

  3. Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Toyofumi F. Chen-Yoshikawa

  4. Organ Transplant Center, Okayama University Hospital, Okayama, Japan

    Takahiro Oto & Tomoyo Okawa

  5. Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan

    Yoshinori Okada

  6. Division of Organ Transplantation, Tohoku University Hospital, Sendai, Japan

    Miki Akiba

  7. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Kazuo Chin

Authors
  1. Junko Tokuno
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  2. Toru Oga
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  3. Toyofumi F. Chen-Yoshikawa
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  14. Masatsugu Hamaji
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  16. Kazuo Chin
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  17. Hiroshi Date
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Corresponding author

Correspondence to Toyofumi F. Chen-Yoshikawa.

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Conflict of interest

KC received lecture fees from Philips-Respironics. The Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, was previously funded by endowments from Philips-Respironics, Teijin Pharma, Fukuda Denshi, and Fukuda Lifetec Keiji, and is now by Philips-Respironics, Resmed Japan, Fukuda Denshi, and Fukuda Lifetec Keiji, to Kyoto University. We declare that no funding sources influenced the preparation of the any part of this manuscript including collection, interpretation, and presentation of the data.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tokuno, J., Oga, T., Chen-Yoshikawa, T.F. et al. Sleep quality and its association with health-related quality of life of patients on lung transplantation waitlist in Japan. Sleep Breath 25, 219–225 (2021). https://doi.org/10.1007/s11325-020-02092-3

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  • DOI: https://doi.org/10.1007/s11325-020-02092-3

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