Prevalence and associations of insomnia in lung transplant recipients

  • Shaun W. YoEmail author
  • Louise M. Fuller
  • Catherine Martin
  • Matthew T. Naughton
  • Gregory I. Snell
  • Eli Dabscheck
Original Article


The burden of comorbidities post-lung transplant is well documented; however, there remains a paucity of studies on insomnia in this population. Sleep disturbance has been well documented in other organ transplants. We evaluated the prevalence and potential associations of insomnia in a lung transplant cohort. A cross-sectional study of lung transplant patients attending routine follow-up at a lung transplant clinic was conducted. Participants completed the Insomnia Severity Index (ISI) and Hospital Anxiety and Depression Scale (HADS). Insomnia was defined as ISI score ≥ 15. Logistic regression analysis was used to study the relationship with variables including demographics, transplant and immunosuppression characteristics, and HADS scores for anxiety (HADS-A) and depression (HADS-D). Eighty-one patients were recruited (age 57 ± 13 years; 35 women). Median time since transplantation was 350 days (128–1228). The prevalence of insomnia was 32% (26 of 81). Insomnia was more common amongst women [odds ratio (OR) 5.0, p = 0.002], and associated with HADS-A (OR 1.24, p = 0.004) and HADS-D scores (OR 1.23, p = 0.01). These associations remained significant on multivariable analysis. There was no association with age, lung function, time since transplant, prednisolone dose or Tacrolimus level. We found a high prevalence of insomnia in lung transplant recipients at our institution. This is similar to the results of previous studies on insomnia and sleep quality in lung transplant recipients. Insomnia is potentially associated with female sex, anxiety and depression. Future studies should elucidate the incidence and predictors of insomnia to guide screening and diagnosis.


Anxiety Depression Insomnia Lung transplantation Sleep disorders 



Six-minute walk distance


Body mass index


Forced expiratory volume in 1 s


Forced vital capacity


Hospital anxiety and depression scale


Insomnia Severity Index


Odds ratio


Standard deviation


Sleep-disordered breathing



The authors wish to thank the staff at The Alfred Hospital lung transplant clinic for their invaluable assistance in conducting this study.



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Alfred Hospital Ethics Committee—approval 506/16.

Human and animal rights statement

Research involving human participants.

Informed consent

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

Supplementary material

41105_2019_223_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)


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Copyright information

© Japanese Society of Sleep Research 2019

Authors and Affiliations

  1. 1.Department of Respiratory and Sleep MedicineThe Alfred HospitalMelbourneAustralia
  2. 2.Lung Transplant ServiceThe Alfred HospitalMelbourneAustralia
  3. 3.Department of PhysiotherapyThe Alfred HospitalMelbourneAustralia
  4. 4.Department of Epidemiology and Preventive MedicineMonash UniversityMelbourneAustralia

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