Restless legs syndrome, insomnia, and quality of life after renal transplantation.
OBJECTIVE
Restless legs syndrome (RLS) is associated with insomnia and impaired quality of life (QoL) in patients on maintenance dialysis; however, no information has been published on the association of RLS and QoL in kidney-transplanted patients. In a cross-sectional study, we analyzed the complex relationship between RLS, insomnia, and health-related QoL in kidney-transplanted patients.


METHODS
In a cross-sectional survey at a single transplant center, 1067 patients were invited to participate. Complete data set was available from 785 kidney-transplanted patients. The RLS Questionnaire and the Athens Insomnia Scale were used to assess the prevalence of RLS and insomnia, respectively. QoL was measured using the Kidney Disease QoL-SF Questionnaire.


RESULTS
Patients with RLS were three times more likely to have insomnia than patients without RLS (29% vs. 9%, P=.001), and the presence of RLS was a significant and independent predictor of insomnia in multivariate analysis. The presence of RLS was independently associated with impaired health-related QoL along several QoL domains after statistical adjustment for clinical and sociodemographic covariables. Importantly, this association remained significant even after adjusting for insomnia for some QoL domains.


CONCLUSIONS
RLS is associated with poor sleep, increased odds for insomnia, and impaired QoL in kidney-transplanted patients. Our results suggest that both sleep-related and sleep-independent factors may contribute to the association of RLS and QoL.
Institute of Behavioral Sciences, Fresenius Medical Care Dialysis Center, and 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
Miklos Zsolt
MZ
Molnar
Marta
M
Novak
Lilla
L
Szeifert
Csaba
C
Ambrus
Andras
A
Keszei
Agnes
A
Koczy
Anett
A
Lindner
Szabolcs
S
Barotfi
Andras
A
Szentkiralyi
Adam
A
Remport
Istvan
I
Mucsi
D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011788:Quality of Life / Q000523:psychology*; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D007166:Immunosuppressive Agents; D011241:Prednisone