Ronai Katalin Z, Szentkiralyi Andras, Lazar Alpar S, Ujszaszi Akos, Turanyi Csilla, Gombos Ferenc, Mucsi Istvan, Bodizs Robert, Molnar Miklos Z, Novak Marta
Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.
J Clin Sleep Med. 2017 Apr 15;13(4):557-564. doi: 10.5664/jcsm.6542.
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.
Ninety-five kTx recipients participated in the study (54 males, mean ± standard devation age 51 ± 13 years, body mass index 26 ± 4 kg/m, estimated glomerular filtration rate 53 ± 19 ml/min/1.73 m). 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.
The CES-D score was significantly associated with the amount of stage 2 sleep (r = 0.20, < .05), rapid eye movement (REM) latency (r = 0.21, < .05) and REM percentage (r = -0.24, < .05), but not with the amount of slow wave sleep (r = -0.12, > .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; = .05) and REM latency (β: 0.234; confidence interval: 0.001-0.468; = .05) after adjustment for potential confounders.
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.
抑郁症和睡眠障碍在肾移植（kTx）受者中都非常普遍。然而，这一人群中睡眠与抑郁之间复杂关系的细节尚未得到充分记录。因此，我们调查了现患kTx受者中抑郁症状与睡眠宏观结构参数之间的关联。
95名kTx受者参与了本研究（54名男性，平均±标准差年龄51±13岁，体重指数26±4kg/m²，估计肾小球滤过率53±19ml/min/1.73m²）。通过流行病学研究中心抑郁量表（CES-D）评估抑郁症状。在进行一晚的多导睡眠图检查后，对每次记录进行视觉评分并分析睡眠宏观结构。
CES-D评分与2期睡眠时间（r = 0.20，P <.05）、快速眼动（REM）潜伏期（r = 0.21，P <.05）和REM百分比（r = -0.24，P <.05）显著相关，但与慢波睡眠时间（r = -0.12，P >.05）无关。在多变量线性回归模型中，调整潜在混杂因素后，CES-D评分与2期睡眠时间（β：0.205；置信区间：0.001 - 0.409；P =.05）和REM潜伏期（β：0.234；置信区间：0.001 - 0.468；P =.05）独立相关。
kTx受者的抑郁症状与2期睡眠时间增加和REM潜伏期延长有关。需要进一步研究来证实我们的发现并了解潜在的临床意义。
