Self-Reported Sleep Duration, Death-Censored Graft Failure and Health-Related Quality of Life Among Kidney Transplant Recipients: Results From the KNOW-KT Study.
Hee-Yeon Jung, Yu Jin Seo, Kyu Ha Huh, Jae Berm Park, Myung-Gyu Kim, Kyung Pyo Kang, Seungyeup Han, Jang-Hee Cho, Sun-Hee Park, Chan-Duck Kim, Yong-Lim Kim, Jung-Hwa Ryu, Jaeseok Yang
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Abstract
Aim: Sleep duration is associated with cardiovascular events, mortality and rapidly declining kidney function in the general population. Less is known about its impact on transplant outcomes and health-related quality of life (HRQOL) among kidney transplant recipients (KTRs).
Methods: This prospective multicenter longitudinal cohort study included 986 incident KTRs and investigated self-reported sleep duration at the time of kidney transplantation. Analyses were performed to examine associations between sleep duration and biopsy-proven acute rejection, death-censored graft failure, major cardiovascular events, all-cause mortality and HRQOL.
Results: During a median follow-up period of 8 years, the death-censored graft failure rate was significantly higher among patients with sleep durations of ≤ 5 h (adjusted hazard ratio [aHR], 3.69; 95% confidence interval [CI], 1.42-9.57; p = 0.007), 6 h (aHR, 3.25; 95% CI, 1.34-7.87; p = 0.009), 8 h (aHR, 2.93; 95% CI, 1.22-7.01; p = 0.016) and ≥ 9 h (aHR, 3.58; 95% CI, 1.29-9.93; p = 0.014), compared to patients with a 7-h sleep duration. Sleep duration was not significantly associated with biopsy-proven acute rejection, major cardiovascular events or all-cause mortality. Multivariable linear regression demonstrated that shorter sleep duration (≤ 5 h) was associated with lower HRQOL, indicated by decreases in the physical component summary score (β, -4.51; 95% CI, -8.75 to -0.26; p = 0.038) and mental component summary score (β, -5.47; 95% CI, -10.29 to -0.65; p = 0.026), relative to patients with a 7-h sleep duration.
Conclusion: Compared to a 7-h sleep duration, both shorter and longer sleep durations were associated with a significantly higher risk of death-censored graft failure among incident KTRs. Additionally, short sleep duration was significantly correlated with impaired HRQOL.
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