Quality of sleep and associated factors among people living with HIV/AIDS on follow up at Ethiopian Zewditu memorial hospital, 2018

Abstract

Background Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness, it remains under-recognized and under-studied in Ethiopia. Therefore it is necessary to produce scientific evidence to fill the knowledge gap and areas of management. The current study aimed to assess sleep quality and its associated factors among people living with HIV/AIDS. Methods An institution-based cross-sectional study was utilized among 408 participants who were selected by a systematic random sampling technique at Zewditu memorial hospital from April to May 2018. The Pittsburgh Sleep Quality Index questionnaire was used to measure sleep quality. Ethical clearance was obtained from the joint ethics committee of the University of Gondar and Amanuel Mental Specialized Hospital. Oral informed consent was obtained from each participant. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI) was computed. Results The magnitude of poor sleep quality was 55.6%. Being female [AOR = 3.40, 95% CI: (1.80, 6.41)], depression [AOR =3.52, 95% CI: (1.95, 6.32)], CD4count ≤ 200 cells/mm3 [AOR = 3.18,95%CI: (1.65,6.13)], duration of HIV/AIDS diagnosis [AOR = 3.43,95% CI: (1.61,7.29)], current use of tobacco [AOR = 5.69, 95% CI: (2.04,15.9)] and chat or caffeinated drinks [AOR = 2.65, 95% CI: (1.06,6.64)] and poor sleep hygiene [AOR = 3.55, 95% CI: (1.85, 6.78)] were significantly associated with poor sleep quality. Conclusions More than half of the study participants were found to have poor sleep quality. A range factors influence quality of sleep of people with HIV/AIDS. Routine screening of sleep condition among people living with HIV/AIDS and early intervention based on the findings is suggested.

Relationships Among Trajectories of Sleep Disturbance, Depression, and Antiretroviral Therapy in Persons Newly Diagnosed with HIV: A One-and-a-Half-Year Observational Longitudinal Study

“…Our study result is somewhat in agreement with previous studies that included HIV patients with HAART. 12,[14][15][16][17][18] In addition, the findings in the current study were similar to the results reported in China, which showed that the level of depression decreased from 23.0% at baseline to 14.0% at month 12 posttreatment. 11 Also consistent with a prospective observational study conducted by Downing et al, 12 the result showed that two sleep quality trajectory groups (bad sleep quality maintained and sleep quality negative change) were highly associated with depression.…”

“…Factors associated with poor sleep quality in PLWH, such as getting older and a higher intensity of depression, were also found in our study. 4 , 16 , 17 The relationship between getting older and poor sleep quality might be related to various factors, such as age-related sleep architecture and growth hormone changes. 33 Given the association between poor sleep and emotional disorders, there might be linkages between sleep, emotional regulation and alteration in the hypothalamic–pituitary–adrenal axis implication of psychopathology and sleep–wake cycle.…”

“…12 Moreover, a 6-year follow-up study show PLWH with undetectable viral load are more likely to be in the recovery pattern than those with higher viral load, but CD4 count and use of HAART were not associated with certain trajectories. 13 Although most of the prior cross-sectional investigations that applied questionnaires indicated that sleep and emotional disturbances are common problems among PLWH, [14][15][16][17][18] prospective follow-up of sleep patterns among HIV-infected persons receiving antiviral drug treatment is still rare. 19 To our knowledge, two prospective studies investigated sleep changes over time in PLWH.…”

The role of material deprivations in determining ART adherence: Evidence from a conjoint analysis among HIV-positive adults in Uganda

“…Increasing fatigue (and relatedly poor quality of sleep) and pain are somatic symptoms of depression which may be caused by HIV illness, and they can also make ART adherence worse [55]. Evidence from different settings in Ethiopia and South Africa shows increased odds of poor sleep quality among depressed PLWH [23,56]. Smaller impacts of these factors on self-reported adherence may not be surprising given that only 7% of our study sample reported high levels of depressive symptoms (Table 3).…”

“…When evaluating the impact of different interventions to improve sleep quality, the authors demonstrate that improved sleep (in the form of naps) can alter decision-making (e.g., savings, increase attention to incentives, and reduce present bias) [21]. Evidence has shown that almost half of PLWH in some settings (such as in Ethiopia or Nigeria) report significant sleep disturbances, including difficulty falling asleep, waking up at night, and reduced sleep time [22][23][24]. Poor sleep may be a contributor to disease progression and further HIV-related morbidity primarily because of how it impairs the immune system and affects physical performance, cognitive function and emotion that could then influence medication adherence [25,26].…”