A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation.
OBJECTIVE
Sleep and fatigue difficulties appear to be highly prevalent among individuals with end-stage renal disease and individuals who have received a kidney transplant. While there is some evidence of biopsychosocial factors predicting sleep disturbance in these populations, previous studies have relied on single time point retrospective measurements.


METHODS
The study utilized a 2-week prospective measurement approach, including one night of polysomnographic measurement, nightly sleep diaries, and self-report measures of health, sleep, and mood.


RESULTS
The current study demonstrates that a number of psychological and behavioral factors, including negative mood, quality of life, napping, and caffeine consumption, are related to sleep disturbance among pre- and post-kidney transplant patients. This study also found that many of these factors have different relationships with sleep disturbance when comparing pre- and post-kidney transplant patients.


CONCLUSIONS
These results suggest that such factors may be worthwhile areas for intervention in treating the symptoms of insomnia among pre- and post-transplant recipients. A nuanced approach to understanding sleep problems is likely warranted when conceptualizing insomnia and developing a treatment plan.
Department of Psychology/Neuropsychology, TIRR Memorial Hermann, Houston, TX.
Jacob M
JM
Williams
Department of Health Psychology, University of Missouri, Columbia, MO.
Christina S
CS
McCrae
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA.|Department of Psychiatry, Harvard Medical School, Boston, MA.
James R
JR
Rodrigue
School of Physician Assistant Studies, University of Florida, Gainesville, FL.
Pamela R
PR
Patton
D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000523:psychology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D008962:Models, Theoretical; D017286:Polysomnography; D011446:Prospective Studies; D011584:Psychology; D057566:Self Report; D012893:Sleep Wake Disorders / Q000209:etiology*
insomnia; kidney transplantation; sleep disorders