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Prevalence and associations of insomnia in lung transplant recipients

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Abstract

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.

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Abbreviations

6MWD:

Six-minute walk distance

BMI:

Body mass index

FEV1:

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

HADS:

Hospital anxiety and depression scale

ISI:

Insomnia Severity Index

OR:

Odds ratio

SD:

Standard deviation

SDB:

Sleep-disordered breathing

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Acknowledgements

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

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Authors and Affiliations

  1. Department of Respiratory and Sleep Medicine, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Shaun W. Yo, Matthew T. Naughton & Eli Dabscheck

  2. Lung Transplant Service, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Shaun W. Yo & Gregory I. Snell

  3. Department of Physiotherapy, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Louise M. Fuller

  4. Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia

    Catherine Martin

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  1. Shaun W. Yo
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Correspondence to Shaun W. Yo.

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The Alfred Hospital Ethics Committee—approval 506/16.

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Yo, S.W., Fuller, L.M., Martin, C. et al. Prevalence and associations of insomnia in lung transplant recipients. Sleep Biol. Rhythms 17, 389–395 (2019). https://doi.org/10.1007/s41105-019-00223-2

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