Non-pharmacological interventions for improving sleep in people living with HIV: a systematic narrative review

Abstract

BackgroundSleep disturbances are common in people living with Human Immunodeficiency Virus (HIV) and may lead to poor adherence to antiretroviral therapy and worsen HIV symptom severity. Due to the side effects of pharmacotherapy for sleep disturbances, there is more room for non-pharmacological interventions, but knowledge of how these non-pharmacological interventions have been used to improve sleep in people living with HIV (PLWH) is still missing.ObjectiveTo investigate the content of non-pharmacological interventions, sleep measurements, and the impact of these interventions on improving sleep in PLWH.MethodsFollowing PRISMA guidelines, we conducted a systematic search on PubMed, EMBASE, Cochrane Central Registry of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc. Non-pharmacological interventions for improving sleep in PLWH were included, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. We performed a narrative approach to synthesize the data to better understand the details and complexity of the interventions.ResultsFifteen experimental studies in three categories for improving sleep in PLWH were included finally, including psychological interventions (components of cognitive-behavioral therapy for insomnia or mindfulness-based cognitive therapy, n = 6), physical interventions (auricular plaster therapy, acupuncture, and exercise, n = 8), and elemental interventions (speed of processing training with transcranial direct current stimulation, n = 1). Wrist actigraphy, sleep diary, and self-reported scales were used to measure sleep. Psychological interventions and physical interventions were found to have short-term effects on HIV-related sleep disturbances.ConclusionsPsychological and physical interventions of non-pharmacological interventions can potentially improve sleep in PLWH, and the combination of patient-reported outcomes and actigraphy devices can help measure sleep comprehensively. Future non-pharmacological interventions need to follow protocols with evidence-based dosing, contents, and measures to ensure their sustainable and significant effects.

Clinical research progress on acupuncture for the treatment of otogenic vertigo

“…Moxibustion refers to the warm stimulation of moxibustion fire with fuel such as moxa wool at acupoints or lesions to achieve a balance of the viscera and smooth the qi and blood. Studies have found that the acupuncture and moxibustion method of warming the governor vessel and removing haze is used to promote the absorption of inflammation and hyperplastic tissues through acupuncture at the local acupoints of the governor vessel and five senses to achieve this warming and clearing of the orifices[ 32 ]. It has been reported that acupotomology in combination with moxibustion using a clear moxa stick can substantially reduce dizziness, headache, and neck and shoulder pain in patients with otogenic vertigo and improve the patient’s quality of life with good long-term efficacy[ 33 ].…”