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Sleep disturbances in children and adolescents after kidney transplantation

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Abstract

Background

Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population.

Methods

Caregivers of kidney transplant recipients completed online questionnaires about their child’s sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records.

Results

Thirty-five children were included in the study, with a median (IQR) age of 14.1 years (9.5–16.1) and median years (IQR) since transplant of 3.7 (0.7–8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1 h before bed.

Conclusions

A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.

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Data Availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

The authors would like to thank the patients and their caregivers who agreed to participate in this study. We would also like to acknowledge Dr. Kylie-Ann Mallitt for statistical guidance.

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Authors and Affiliations

  1. Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia

    Mian Yang, Sandra Ya-Chu Chuang & Sean E. Kennedy

  2. Respiratory Department, Sydney Children’s Hospital, Randwick, NSW, Australia

    Sandra Ya-Chu Chuang

  3. Nephrology Department, Sydney Children’s Hospital, Randwick, NSW, Australia

    Sean E. Kennedy

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  1. Mian Yang
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  3. Sean E. Kennedy
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Correspondence to Mian Yang.

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Ethics approval

This study was approved by the Sydney Children’s Hospital Network Human Research Ethics Committee (LNR/17/SCHN/512). The procedures used in this study adhere to the ethical standards of the research committee and as described in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent to participate and to publish was obtained from all participants and/or their caregivers included in the study.

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Yang, M., Chuang, S.YC. & Kennedy, S.E. Sleep disturbances in children and adolescents after kidney transplantation. Pediatr Nephrol 39, 1577–1585 (2024). https://doi.org/10.1007/s00467-023-06204-5

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