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Journal of Clinical Sleep Medicine (JCSM) 13:(4) pp. 557–564. (2017)

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DOI: 10.5664/jcsm.6542

Katalin Z. Ronai, MD1; Andras Szentkiralyi, MD, PhD1,2; Alpar S. Lazar, PhD1,3; Akos Ujszaszi, MD, PhD4; Csilla Turanyi, MD, PhD1; Ferenc Gombos, MSc5; Istvan Mucsi, MD, PhD1,6; Robert Bodizs, PhD1,5; Miklos Z. Molnar, MD, PhD7,8; Marta Novak, MD, PhD1,9

1Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary;

2Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany;

3Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom;

4Institute of Pathophysiology, Semmelweis University, Budapest, Hungary;

5Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary; 6Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada;

7Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Tennessee;

8Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary;

9Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Canada



Study Objectives

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/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.


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.


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.

 Keywords: depressive symptoms, sleep quality, kidney transplant recipients
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