Characterizing Perioperative Sleep in Acute Renal Transplants

Abstract

Introduction: Posttransplant sleep disturbances may influence recovery, immunosuppressive adherence, and graft outcomes. This study examined sleep disruption in acute renal transplant recipients and its relationship with medication comprehension and hospital stressors. Methods/Approach: A mixed-methods, pilot prospective cohort study was conducted at a metropolitan hospital in Australia. Consecutive renal transplant patients were recruited. Perioperative sleep patterns were assessed using the American Academy of Sleep Medicine's sleep diary. The Kidney Transplant Understanding Tool evaluated medication comprehension. Qualitative data from semistructured interviews were analysed using inductive content analysis. Univariate linear regression assessed associations between sleep and perioperative outcomes (P ≤ .05). Findings: Ten recipients were recruited. Recipients averaged 5.2 hours of sleep per night with frequent disruptions. Sleep ranged from 0 to 10 hours per night, with the longest sleepless period being 41 hours. An inverse correlation was observed between sleep duration and medication comprehension scores(β=-8.736, P = .0232), suggesting recipients with less sleep had better medication comprehension. Qualitative analysis identified sleep disruptions due to hospital practices, environmental factors, transplant-related stress, and medication side effects. Conclusion: Perioperative sleep disturbances were multifactorial, influenced by hospital and procedural factors. The paradoxical association between reduced sleep and increased medication comprehension highlights a complex interplay between stress, sleep, and cognitive engagement. This pilot study suggested that addressing sleep disturbances and incorporating culturally sensitive education may enhance perioperative care. However, further research is needed to validate these findings in larger cohorts.