Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients.
OBJECTIVE
Both depression and sleep complaints are very prevalent among kidney transplant (kTx) recipients. However, details of the complex relationship between sleep and depression in this population are not well documented. Thus, we investigated the association between depressive symptoms and sleep macrostructure parameters among prevalent kTx recipients.


METHODS
Ninety-five kTx recipients participated in the study (54 males, mean ± standard devation age 51 ± 13 years, body mass index 26 ± 4 kg/m2, estimated glomerular filtration rate 53 ± 19 ml/min/1.73 m2). Symptoms of depression were assessed by the Center for Epidemiologic Studies - Depression Scale (CES-D). After 1-night polysomnography each recording was visually scored and sleep macrostructure was analyzed.


RESULTS
The CES-D score was significantly associated with the amount of stage 2 sleep (r = 0.20,P< .05), rapid eye movement (REM) latency (r = 0.21,P< .05) and REM percentage (r = -0.24,P< .05), but not with the amount of slow wave sleep (r = -0.12,P> .05). In multivariable linear regression models the CES-D score was independently associated with the amount of stage 2 sleep (β: 0.205; confidence interval: 0.001-0.409;P= .05) and REM latency (β: 0.234; confidence interval: 0.001-0.468;P= .05) after adjustment for potential confounders.


CONCLUSIONS
Depressive symptoms among kTx recipients are associated with increased amount of stage 2 sleep and prolonged REM latency. Further studies are needed to confirm our findings and understand potential clinical implications.
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
Katalin Z
KZ
Ronai
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.|Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.
Andras
A
Szentkiralyi
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.|Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom.
Alpar S
AS
Lazar
Institute of Pathophysiology, Semmelweis University, Budapest, Hungary.
Akos
A
Ujszaszi
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
Csilla
C
Turanyi
Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary.
Ferenc
F
Gombos
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.|Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada.
Istvan
I
Mucsi
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.|Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary.
Robert
R
Bodizs
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Tennessee.|Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Miklos Z
MZ
Molnar
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.|Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Canada.
Marta
M
Novak
D003866:Depressive Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011183:Postoperative Complications / Q000503:physiopathology* / Q000523:psychology; D012890:Sleep; D012894:Sleep Stages / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology
REM sleep; depression; kidney transplant recipients; slow wave sleep; stage 2 sleep