Physiological and Psychological Correlates of Sleep in HIV Infection

Abstract

Insomnia, a common problem associated with HIV disease, is most likely caused by a multitude of factors. This study investigated the correlations between a selected group of physiological and psychological factors and sleep quality in an HIV-infected population. A convenience sample of 79 ethnically diverse HIV-positive adults, ages 24 to 63, completed a number of questionnaires and released their laboratory records for CD4+ cell count and viral load information. Variables significantly related to sleep quality were HIV-related symptoms, total pain, fatigue, depression, state anxiety, and the number of adults in the household. Findings support the need for health care providers to consider factors that contribute to impaired sleep when developing effective care for HIV-infected individuals with sleep disturbance.

Types of Sleep Problems in Adults Living with HIV/AIDS

“…Using the PSQI self-report measure, other researchers also report a range of 2 to 12 hours, with a mean of 5 to 6 hours sleep and sleep efficiency better than 85% in their samples of HIVinfected adults. 9,32 to complain about their sleep, and since their sleep efficiency was similar to the group of good sleepers, interventions may be better focused on strategies to relieve anxiety and restrict time spent in bed in order to shorten sleep onset latency. 35,36 Rather than relying solely on medication to improve sleep, cognitive behavioral therapy should also be considered, particularly in populations already burdened with medications used to manage their chronic illness.…”

“…Sleep disturbance is not only prevalent, but also one of the more intense and distressful symptoms experienced in this population. [8][9][10] In HIV infection, poor sleep has been associated with disease progression, medication therapy, employment status, and lack of knowledge about behaviors that promote good sleep. [11][12][13][14] The specifi c type of sleep disturbance experienced by this population needs to be better understood in order to provide the most effective intervention to improve symptoms, daytime functioning, and quality of life.…”

“…1 Adults living with a chronic illness are at higher risk for sleep problems, and depending on the definition, sleep problems are experienced by 30% to 100% of HIVpositive adults. [2][3][4][5][6][7][8][9] It is unclear what type of sleep problem adults with HIV experience, or whether their sleep disturbance is related to the infection itself or to the medical treatment and side effects of medications. Sleep disturbance is not only prevalent, but also one of the more intense and distressful symptoms experienced in this population.…”

HIV Medication Adherence and HIV Symptom Severity: The Roles of Sleep Quality and Memory

“…[10][11][12][13][14][15] For example, Gay and colleagues 13 found that among a sample of 350 participants with HIV, trouble sleeping was the symptom most strongly associated with non-adherence to ART. In addition, previous research has demonstrated that poor sleep quality is associated with self-reported HIV symptom severity among adults with HIV, 17 and lower numbers of CD3 + /CD4 + cells. 18 As such, sleep disturbance may be associated with both HIV medication adherence and self-reported HIV symptom severity.…”

“…9 In fact, up to 73% of HIV-positive individuals report significant sleep disturbance, 10 thus rendering poor sleep as one of the most prevalent and debilitating HIV symptoms in both intensity and severity. 11,12 In addition to daytime fatigue, a breadth of research has demonstrated that disturbed sleep, among individuals with HIV, is associated with non-adherence to ART, [13][14][15] increased disease progression, 16,17 and decreased immune functioning, 18 both pre-and post-modern ART era. [10][11][12][13][14][15] For example, Gay and colleagues 13 found that among a sample of 350 participants with HIV, trouble sleeping was the symptom most strongly associated with non-adherence to ART.…”