{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T18:19:38Z","timestamp":1785349178408,"version":"3.55.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl Int"],"abstract":"<jats:p>This study aims to describe daytime sleepiness and health-related quality of life (HRQoL) among Lebanese kidney transplant (KT) recipients and to examine the medical, psychosocial and transplant factors related to them. It is a cross-sectional multi-center study involving KT recipients &amp;gt;18\u00a0years. Daytime sleepiness was assessed using ESS Questionnaire. HRQoL was measured using the SF-36 questionnaire. Social support was self-reported. A multivariable regression analysis evaluated factors associated with daytime sleepiness and HRQoL in our sample. 118 patients were recruited over a 2\u00a0years period. Excessive daytime sleepiness was prevalent in 12.7%. It was associated with Diabetes Mellitus (OR 3.97, 95% CI 0.94\u201316.81, <jats:italic>p<\/jats:italic> = 0.06) and obesity (OR 1.13, 95% CI 1.02, 1.27, <jats:italic>p<\/jats:italic> = 0.02). Social support and higher eGFR were associated with better scores on the MCS (\u03b2 24.13 <jats:italic>p<\/jats:italic> &amp;lt; 0.001 and \u03b2 0.26 <jats:italic>p<\/jats:italic> &amp;lt; 0.01) and the PCS (\u03b2 15.48 <jats:italic>p<\/jats:italic> &amp;lt; 0.01 and \u03b2 0.22 P 0.02). Conversely, depression and hospitalization were negatively associated with the MCS (\u03b2 \u221227.44, <jats:italic>p<\/jats:italic> &amp;lt; 0.01 and \u03b2 \u22129.87, <jats:italic>p<\/jats:italic> &amp;lt; 0.01) and the PCS (\u03b2 \u22120.28.49, <jats:italic>p<\/jats:italic> &amp;lt; 0.01 and \u03b2 \u221210.37, <jats:italic>p<\/jats:italic> &amp;lt; 0.01).<\/jats:p>","DOI":"10.3389\/ti.2023.11547","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T13:02:48Z","timestamp":1698843768000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Sleepiness and Health-Related Quality of Life Among Kidney Transplant Recipients in a Low-Middle Income Country: A Cross-Sectional Study"],"prefix":"10.3389","volume":"36","author":[{"given":"Mayssaa","family":"Hoteit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Al-Masry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Elbejjani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabel","family":"Aoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Abu-Dargham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Medawar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal","family":"Abou Zeinab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"Farhood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar H.","family":"Koubar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,1]]},"reference":[{"key":"B1","first-page":"S97","article-title":"Renal Transplantation and Sleep: A New Life Is Not Enough","volume":"21","author":"Sabbatini","year":"2008","journal-title":"J Nephrol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1053\/j.ajkd.2005.12.035","article-title":"Chronic Insomnia in Kidney Transplant Recipients","volume":"47","author":"Novak","year":"2006","journal-title":"Am J Kidney Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1186\/1471-2369-14-220","article-title":"Self-Reported Sleep Disturbances in Renal Transplant Recipients","volume":"14","author":"Burkhalter","year":"2013","journal-title":"BMC Nephrol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.trre.2018.09.002","article-title":"Sleep Disorders: Serious Threats Among Kidney Transplant Recipients","volume":"33","author":"Parajuli","year":"2019","journal-title":"Transpl Rev (Orlando)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1034\/j.1399-0012.2003.00028.x","article-title":"Neuropsychologic Side-Effects of Tacrolimus in Pediatric Renal Transplantation","volume":"17","author":"Kemper","year":"2003","journal-title":"Clin Transpl"},{"key":"B6","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1111\/ctr.12255","article-title":"Poor Sleep in Organ Transplant Recipients: Self-Reports and Actigraphy","volume":"27","author":"Reilly-Spong","year":"2013","journal-title":"Clin Transpl"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1016\/j.transproceed.2007.03.011","article-title":"Does Etiology of End-Stage Renal Disease Affect Sleep Quality in Kidney Transplant Recipients?","volume":"39","author":"Ameli","year":"2007","journal-title":"Transpl Proc"},{"key":"B8","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1097\/TP.0b013e31827d9772","article-title":"Health-Related Quality of Life and Long-Term Survival and Graft Failure in Kidney Transplantation: A 12-Year Follow-Up Study","volume":"95","author":"Griva","year":"2013","journal-title":"Transplantation"},{"key":"B9","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1007\/s11096-017-0436-4","article-title":"Factors Relevant to Medication Non-Adherence in Kidney Transplant: A Systematic Review","volume":"39","author":"Belaiche","year":"2017","journal-title":"Int J Clin Pharm"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jpsychores.2017.04.014","article-title":"Social Support From the Closest Person and Sleep Quality in Later Life: Evidence From a British Birth Cohort Study","volume":"98","author":"Stafford","year":"2017","journal-title":"J Psychosom Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.socscimed.2012.05.002","article-title":"Sociodemographic and Cultural Determinants of Sleep Deficiency: Implications for Cardiometabolic Disease Risk","volume":"79","author":"Knutson","year":"2013","journal-title":"Soc Sci Med"},{"key":"B12","volume-title":"About the ESS \u2013 Epworth Sleepiness Scale","year":"2022"},{"key":"B13","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/00005650-199401000-00004","article-title":"The MOS 36-Item Short-Form Health Survey (SF-36): III. Tests of Data Quality, Scaling Assumptions, and Reliability Across Diverse Patient Groups","volume":"32","author":"McHorney","year":"1994","journal-title":"Med Care"},{"key":"B14","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.jegh.2014.04.004","article-title":"Validation of the Arabic Version of the Epworth Sleepiness Scale","volume":"4","author":"Ahmed","year":"2014","journal-title":"J Epidemiol Glob Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1097\/00005650-199803000-00018","article-title":"Reliability of an Arabic Version of the RAND-36 Health Survey and Its Equivalence to the US-English Version","volume":"36","author":"Coons","year":"1998","journal-title":"Med Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"706","DOI":"10.26719\/emhj.19.041","article-title":"Validation of the Arabic Version of the SF-36, Generic Questionnaire of Quality of Life Related to Health Among the Elderly in Lebanon","volume":"25","author":"El Osta","year":"2019","journal-title":"East Mediterr Health J"},{"key":"B17","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/j.rehab.2012.05.003","article-title":"Translation in Arabic, Adaptation and Validation of the SF-36 Health Survey for Use in Tunisia","volume":"55","author":"Guermazi","year":"2012","journal-title":"Ann Phys Rehabil Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2188\/jea.15.1","article-title":"Excessive Daytime Sleepiness Among the Japanese General Population","volume":"15","author":"Kaneita","year":"2005","journal-title":"J Epidemiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1093\/sleep\/20.10.844","article-title":"Daytime Sleepiness and Sleep Habits of Australian Workers","volume":"20","author":"Johns","year":"1997","journal-title":"Sleep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"406","DOI":"10.5144\/0256-4947.1999.406","article-title":"Sleep Disorders in Saudi Health Care Workers","volume":"19","author":"Wali","year":"1999","journal-title":"Ann Saudi Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1155\/2012\/287309","article-title":"Prevalence of High Epworth Sleepiness Scale Scores in a Rural Population","volume":"19","author":"Pahwa","year":"2012","journal-title":"Can Respir J"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1007\/s11325-016-1363-7","article-title":"Normative Values of the Epworth Sleepiness Scale (ESS), Derived From a Large German Sample","volume":"20","author":"Sander","year":"2016","journal-title":"Sleep Breath"},{"key":"B23","doi-asserted-by":"publisher","first-page":"220","DOI":"10.7182\/pit2013788","article-title":"Validation of a Single Item to Assess Daytime Sleepiness for the Swiss Transplant Cohort Study","volume":"23","author":"Burkhalter","year":"2013","journal-title":"Prog Transpl"},{"key":"B24","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1159\/000236900","article-title":"Sleep Disorders in the Older Adult \u2013 A Mini-Review","volume":"56","author":"Neikrug","year":"2010","journal-title":"Gerontology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.clnu.2014.05.003","article-title":"Energy Expenditure, Spontaneous Physical Activity and With Weight Gain in Kidney Transplant Recipients","volume":"34","author":"Heng","year":"2015","journal-title":"Clin Nutr"},{"key":"B26","doi-asserted-by":"publisher","first-page":"E13","DOI":"10.1111\/j.1399-0012.2010.01326.x","article-title":"A Cross-Sectional Study of Fatigue and Sleep Quality Before and After Kidney Transplantation","volume":"25","author":"Rodrigue","year":"2011","journal-title":"Clin Transpl"},{"key":"B27","doi-asserted-by":"publisher","first-page":"608","DOI":"10.3978\/j.issn.2072-1439.2012.10.07","article-title":"Excessive Daytime Sleepiness in Sleep Disorders","volume":"4","author":"Slater","year":"2012","journal-title":"J Thorac Dis"},{"key":"B28","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.amjsurg.2008.11.021","article-title":"Kidney Transplant Complications and Obesity","volume":"197","author":"Olarte","year":"2009","journal-title":"Am J Surg"},{"key":"B29","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1097\/TP.0b013e31817ef0f9","article-title":"Obesity and Cardiac Risk After Kidney Transplantation: Experience at One Center and Comprehensive Literature Review","volume":"86","author":"Lentine","year":"2008","journal-title":"Transplantation"},{"key":"B30","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s11892-018-1055-8","article-title":"The Epidemiology of Sleep and Diabetes","volume":"18","author":"Ogilvie","year":"2018","journal-title":"Curr Diab Rep"},{"key":"B31","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1097\/00063198-200211000-00003","article-title":"Sleep and the Endocrine System: New Associations to Old Diseases","volume":"8","author":"Boethel","year":"2002","journal-title":"Curr Opin Pulm Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.pcad.2008.10.002","article-title":"Reduced Sleep Duration or Quality: Relationships With Insulin Resistance and Type 2 Diabetes","volume":"51","author":"Tasali","year":"2009","journal-title":"Prog Cardiovasc Dis"},{"key":"B33","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.jpsychores.2010.04.003","article-title":"Does Social Support Differentially Affect Sleep in Older Adults With Versus Without Insomnia?","volume":"69","author":"Troxel","year":"2010","journal-title":"J Psychosom Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1093\/sleep\/30.9.1085","article-title":"American Time Use Survey: Sleep Time and Its Relationship to Waking Activities","volume":"30","author":"Basner","year":"2007","journal-title":"Sleep"},{"key":"B35","doi-asserted-by":"publisher","first-page":"21209","DOI":"10.1073\/pnas.2004535117","article-title":"Sleepiness, Sleep Duration, and Human Social Activity: An Investigation Into Bidirectionality Using Longitudinal Time-Use Data","volume":"117","author":"Holding","year":"2020","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2324","DOI":"10.1111\/jcmm.14170","article-title":"Depression in Sleep Disturbance: A Review on a Bidirectional Relationship, Mechanisms and Treatment","volume":"23","author":"Fang","year":"2019","journal-title":"J Cell Mol Med"},{"key":"B37","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1097\/TP.0000000000000901","article-title":"Depression and Anxiety as Risk Factors for Morbidity and Mortality After Organ Transplantation: A Systematic Review and Meta-Analysis","volume":"100","author":"Dew","year":"2015","journal-title":"Transplantation"},{"key":"B38","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12882-018-0893-6","article-title":"Factors Associated With Health-Related Quality of Life in Kidney Transplant Recipients in France","volume":"19","author":"Mouelhi","year":"2018","journal-title":"BMC Nephrol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"774","DOI":"10.4103\/1319-2442.336773","article-title":"Quality of Life Among Renal Transplant Recipients in Bahrain: A Single-Center Experience","volume":"32","author":"El-Agroudy","year":"2021","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"B40","doi-asserted-by":"publisher","first-page":"3329","DOI":"10.1016\/j.transproceed.2018.05.026","article-title":"Quality of Life, Adherence Behavior, and Social Support Among Renal Transplant Recipients in China: A Descriptive Correlational Study","volume":"50","author":"Zhao","year":"2018","journal-title":"Transpl Proc"},{"key":"B41","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1053\/j.ajkd.2019.08.026","article-title":"Perceived Health and Quality of Life in Patients With CKD, Including Those With Kidney Failure: Findings From National Surveys in France","volume":"75","author":"Legrand","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/s0090-4295(00)00623-3","article-title":"Assessment of Health-Related Quality of Life in Renal Transplant and Hemodialysis Patients Using the SF-36 Health Survey","volume":"56","author":"Fujisawa","year":"2000","journal-title":"Urology"},{"key":"B43","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/1477-7525-11-88","article-title":"Factors Associated With Health-Related Quality of Life in Renal Transplant Recipients: Results of a National Survey in France","volume":"11","author":"Gentile","year":"2013","journal-title":"Health Qual Life Outcomes"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.congress-2015.PA3547","article-title":"Impact of Hospitalization in the Functionality and Quality of Life of Adults and Elderlies","volume":"46","author":"Meira","year":"2015","journal-title":"Eur Respir J"},{"key":"B45","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.genhosppsych.2016.08.005","article-title":"Anxiety Symptoms in Survivors of Critical Illness: A Systematic Review and Meta-Analysis","volume":"43","author":"Nikayin","year":"2016","journal-title":"Gen Hosp Psychiatry"},{"key":"B46","doi-asserted-by":"publisher","first-page":"267","DOI":"10.5500\/wjt.v4.i4.267","article-title":"Psychopathological Aspects of Kidney Transplantation: Efficacy of a Multidisciplinary Team","volume":"4","author":"De Pasquale","year":"2014","journal-title":"World J Transpl"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1038\/ki.2009.51","article-title":"Depression Is an Important Contributor to Low Medication Adherence in Hemodialyzed Patients and Transplant Recipients","volume":"75","author":"Cukor","year":"2009","journal-title":"Kidney Int"}],"container-title":["Transplant International"],"original-title":[],"link":[{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/ti.2023.11547\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T13:03:11Z","timestamp":1698843791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/ti.2023.11547\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,1]]},"references-count":47,"alternative-id":["10.3389\/ti.2023.11547"],"URL":"https:\/\/doi.org\/10.3389\/ti.2023.11547","relation":{},"ISSN":["1432-2277"],"issn-type":[{"value":"1432-2277","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,1]]},"article-number":"11547"}}