The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic

Abstract

Background The psychological distress and sleep problems caused by current Covid-19 outbreak is not well known in kidney transplant recipients. In this study, we aimed to investigate the association between perceived stress with sleep quality, insomnia, anxiety, depression and kidney function in kidney transplant recipients during the Covid-19 pandemic. Material and methods A hundred-six kidney transplant recipients were enrolled. Questionnaire of "Socio-demographics", "Perceived Stress Scale (PSS)", "Pittsburgh Sleep Quality Index (PSQI)", "Insomnia Severity Index (ISI)" and “Hospital Anxiety Depression Scale (HADS)” are performed. The laboratory data is recorded. The perceived stress related to Covid-19 pandemic and its associations were investigated. Results The mean age of patients was 44.2±13.3 years, and 65 of the patients (61.3%) were men. Forty-nine (46.2%) of the patients had high-perceived stress; 51 (48.1%) of the patients had poor sleep quality, 40 (37.7%) of the patients had insomnia, 25 (23.6%) of the patients had anxiety and 47 (44.3%) of the patients had depression. The patients having a history of Covid-19 infection in own or closed relatives (9.09±4.17 vs 6.49±4.16, p:0.014) and the patients who have a rejection episode any of time (8.24±5.16 vs 6.37±3.57, p:0.033) have had significantly higher anxiety scores, when they compared to others. The high PSS were positively correlated with PSQI, ISI, HAD-A and HAD-D. Regression analyses revealed that high-perceived stress is an independent predictor of anxiety and depression. There was not significant difference between kidney function with PSS, PSQI, ISI, HAD-A and HAD-D. Conclusions High PSS is positively correlated with poor sleep quality and insomnia and also an independent predictor of anxiety and depression in kidney transplant recipients during the outbreak of Covid-19. As the pandemic is still spreading worldwide quickly early identification and intervention of sleep disturbances and psychiatric disorders are essential to protect graft function with high compliance to treatment in transplantation patients.

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

“…A total of 250 studies [285 subgroups, i.e., multiple populations, multiple tools, or multiple data points] comprising 493,475 participants from 49 countries were included in the analyses [ [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] , [100] , [101] , [102] , [103] , [104] , [105] , [106] , [10...…”

“… PSQI, ISI 7 24 Assenza et al, 2020 [ 66 ] Italy No General Population Cross-sectional design, N = 928, Female = 74.5%, Age = 18-86 years. PSQI 8 25 Atas et al, 2021 [ 67 ] Turkey Yes Special Population Cross-sectional design, N = 106, Female = 38.7%, Age = 44.2 years. PSQI, ISI 5 26 Bacaro et al, 2020 [ 68 ] Italy Yes General Population Cross-sectional design, N = 1989, Female = 76.2%, Age = 38.4 years.…”

Demographic and mental health assessments in the adolescent brain and cognitive development study: Updates and age-related trajectories

“…The Perceived Stress Scale (PSS) was first published by Cohen and colleagues in 1983 ( Cohen et al, 1983 ). The PSS is an accessible and effective metric of perceived stress, and has demonstrated utility in understanding the relationship between stress and a myriad of both behavioral and health endpoints ( Golden-Kreutz and Thornton, 2005 , Robles and Garey, 2016 , Whitehead and Bergeman, 2017 , Barutcu Atas and Aydin Sunbul, 2021 ). In addition to predictive value for outcomes specific to the individual completing the PSS, this metric has also proven useful in understanding the role of parental perceived stress in adolescent-related outcomes ( Slaughter and Hamilton, 2020 , Koning and Vink, 2021 , Tara and Turpyn, 2021 ).…”

Special Issue: Demographic and Mental Health Assessments in the Adolescent Brain and Cognitive Development Study: Updates and Longitudinal Trajectories

“…The Perceived Stress Scale (PSS) was first published by Cohen and colleagues in 1983 (Cohen et al 1983). The PSS is an accessible and effective metric of perceived stress, and has demonstrated utility in understanding the relationship between stress and a myriad of both behavioral and health endpoints (Golden-Kreutz et al 2005; Robles et al 2016; Whitehead and Bergeman 2017; Barutcu Atas et al 2021). In addition to predictive value for outcomes specific to the individual completing the PSS, this metric has also proven useful in understanding the role of parental perceived stress in adolescent-related outcomes (Slaughter et al 2020; Koning et al 2021; Tara et al 2021).…”