Exploring Factors Associated with Sleep Quality After Lung Transplantation

Introduction: Sleep quality after lung transplant is important for recovery, overall health, and performance of healthy behaviors, such as exercise. Research Aim: The purpose of this study was to explore the associations between sleep quality and factors likely to influence and/or be influenced by sleep. Design: This was a secondary analysis of data from a randomized controlled trial of a tele-rehab exercise intervention for lung transplant recipients. Baseline demographic and clinical characteristics, sleep quality, physical activity, symptom burden, and psychological distress data were collected. Multivariate logistic regression model was used to identify factors associated with poor sleep quality. Results: Participants (N=88) were aged 56.4 (13.0) years and male (54.5%). Seventy-four percent of the patients met the established cut-off for poor sleep quality and the mean Pittsburgh Sleep Quality Index total score was 7.1 (3.7). Recipients reported anxiety (n=21, 23.9%) and depression (n=27, 30.7%). When lung-specific items of the sleep questionnaire were explored, the reported presence of cough or snoring loudly was associated with poor sleep (P = .010). Patients reporting any psychological distress (n=33, 37.5%) had increased odds of experiencing poor sleep (odds ratio [OR]=13.72; 95% confidence interval [CI] =2.33, 264.7.01; P=.017). In a model examining respiratory symptoms concurrently, wheezing increased the odds of reporting poor sleep quality (OR=10.88, 95% CI=1.65, 222.02; P=.037). Conclusion: Clinical attention is needed to detect and manage symptom burden and psychological distress to improve sleep quality and optimize posttransplant recovery among lung recipients. Future studies examining these variables are needed to help guide screening and treatment protocols.