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Bourne K, Croston M, Hurt E, Galbraith N, Hayter M. What is known from the existing literature about how sleep is measured in HIV care? A scoping review. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S10-V. [PMID: 38194326 DOI: 10.12968/bjon.2024.33.1.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
The HIV care landscape has significantly altered over the past 30 years with advances in HIV medical treatment. Despite these medical advances, people living with HIV experience a significant number of issues that affect their health-related quality of life, including sleep. Although poor sleep quality is common, there remains a lack of understanding of how to identify sleep issues in order to improve outcomes for people living with HIV. A scoping review of three databases as well as the grey literature yielded 2932 articles, of which 60 met the inclusion criteria. The following themes were identified: range of methods used to assess sleep, self-reported sleep measures and objective measures of sleep. The review found that a number of different measures of sleep were used within the research, the most commonly used being the Pittsburgh Sleep Quality Index. Due to the variety of approaches being used to measure sleep (n=18) there was a lack of consistency in what aspects of sleep were being explored, and in many cases why the measure of sleep was chosen. Furthermore, there was a lack of meaningful clinical recommendations as to how these findings could be used to improve outcomes for people living with HIV.
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Affiliation(s)
- Kathryn Bourne
- Clinical Psychologist, Department of Infectious Diseases, Manchester University NHS Foundation Trust, and Lecturer in Clinical Psychology, Faculty of Health and Medicine, Lancaster University
| | - Michelle Croston
- Associate Professor of Nursing, School of Health Sciences, University of Nottingham, Nottingham
| | - Emily Hurt
- Research Assistant, Manchester Metropolitan University
| | | | - Mark Hayter
- Professor and Head of Nursing, Manchester Metropolitan University
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Associations Between Wearable-Specific Indicators of Physical Activity Behaviour and Insulin Sensitivity and Glycated Haemoglobin in the General Population: Results from the ORISCAV-LUX 2 Study. SPORTS MEDICINE - OPEN 2022; 8:146. [PMID: 36507935 PMCID: PMC9743939 DOI: 10.1186/s40798-022-00541-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parameters derived from an acceleration signal, such as the time accumulated in sedentary behaviour or moderate to vigorous physical activity (MVPA), may not be sufficient to describe physical activity (PA) which is a complex behaviour. Incorporating more advanced wearable-specific indicators of PA behaviour (WIPAB) may be useful when characterising PA profiles and investigating associations with health. We investigated the associations of novel objective measures of PA behaviour with glycated haemoglobin (HbA1c) and insulin sensitivity (Quicki index). METHODS This observational study included 1026 adults (55% women) aged 18-79y who were recruited from the general population in Luxembourg. Participants provided ≥ 4 valid days of triaxial accelerometry data which was used to derive WIPAB variables related to the activity intensity, accumulation pattern and the temporal correlation and regularity of the acceleration time series. RESULTS Adjusted general linear models showed that more time spent in MVPA and a higher average acceleration were both associated with a higher insulin sensitivity. More time accumulated in sedentary behaviour was associated with lower insulin sensitivity. With regard to WIPAB variables, parameters that were indicative of higher PA intensity, including a shallower intensity gradient and higher average accelerations registered during the most active 8 h and 15 min of the day, were associated with higher insulin sensitivity. Results for the power law exponent alpha, and the proportion of daily time accumulated in sedentary bouts > 60 min, indicated that activity which was characterised by long sedentary bouts was associated with lower insulin sensitivity. A greater proportion of time spent in MVPA bouts > 10 min was associated with higher insulin sensitivity. A higher scaling exponent alpha at small time scales (< 90 min), which shows greater correlation in the acceleration time series over short durations, was associated with higher insulin sensitivity. When measured over the entirety of the time series, metrics that reflected a more complex, irregular and unpredictable activity profile, such as the sample entropy, were associated with lower HbA1c levels and higher insulin sensitivity. CONCLUSION Our investigation of novel WIPAB variables shows that parameters related to activity intensity, accumulation pattern, temporal correlation and regularity are associated with insulin sensitivity in an adult general population.
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Pujasari H, Chung MH. Sleep Disturbance in the Context of HIV: A Concept Analysis. SAGE Open Nurs 2022; 8:23779608221094541. [PMID: 35493547 PMCID: PMC9039437 DOI: 10.1177/23779608221094541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/24/2022] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Due to the differing definitions of the concept of sleep disturbance among people living with human immunodeficiency virus (HIV), reviewers in this area have not reached any firm conclusions. The study aimed to clarify and provide a stronger foundation for the definition of sleep disturbance in the context of HIV to enhance the concept’s development. Following Beth Rodgers’ concept analysis guidelines, two leading databases were searched, and 73 articles were used for this concept analysis. The attributes, surrogate terms, antecedents, and consequences of sleep disturbance have been identified using thematic analysis. In this analysis, two main attributes of sleep disturbance in the context of HIV were identified: a) subjective measures, including reduced total sleep time, difficulty falling asleep, nighttime and early morning awakenings, feeling sleepy and poorly rested after a night’s sleep, frequent arousals, and irritability, and b) objective measures, including changes in sleep architecture and sleep continuity. Five antecedents of sleep disturbance in the context of HIV were identified. Meanwhile, the consequences of sleep disturbance in HIV are listed based on the frequency the points occur within the reviewed articles. The list is as follows: fatigue and pain; reduced neurocognitive functions; reduced health outcome and quality of life; poor anti-retroviral (ARV) therapy adherence; daytime sleepiness; depression, anxiety, and maladaptive coping; increased disease progression and cardiovascular mortality; and social phobia, living arrangement and sexual dysfunction. An improved understanding of sleep disturbance in the context of HIV will be beneficial in directing analysts to develop research plans. At the same time, the knowledge gaps identified in the analysis provided a solid basis for further study intending to fill in these gaps.
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Affiliation(s)
| | - Min-Huey Chung
- College of Nursing, Taipei Medical University, Taipei, Taiwan
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Daubert E, French AL, Burgess HJ, Sharma A, Gustafson D, Cribbs SK, Weiss DJ, Ramirez C, Konkle-Parker D, Kassaye S, Weber KM. Association of Poor Sleep With Depressive and Anxiety Symptoms by HIV Disease Status: Women's Interagency HIV Study. J Acquir Immune Defic Syndr 2022; 89:222-230. [PMID: 34732681 PMCID: PMC8740603 DOI: 10.1097/qai.0000000000002847] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/04/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Sleep disturbances are prevalent in women living with HIV (WLWH) and can affect mental health and overall quality of life. We examined the prevalence and predictors of poor sleep quality in a US cohort of WLWH and HIV-uninfected controls and the relationship between sleep quality and mental health symptom burden stratified by HIV disease status (viremic WLWH, aviremic WLWH, and HIV-uninfected women). METHODS Sleep quality was assessed using the Pittsburgh Sleep Quality Index in 1583 (400 viremic WLWH, 723 aviremic WLWH, and 460 HIV-uninfected women) Women's Interagency HIV Study participants. Depressive and anxiety symptoms were concurrently assessed using the Center for Epidemiological Studies-Depression (CES-D) scale and General Anxiety Disorder (GAD-7) scale. Associations between poor sleep quality (global Pittsburgh Sleep Quality Index >5) and both high depressive (CES-D ≥16) and anxiety (GAD-7 ≥10) symptoms were each assessed by HIV disease status using multivariable logistic regression models. RESULTS Prevalence of poor sleep quality in the overall sample was 52%, differed by HIV disease status (P = 0.045), and was significantly associated with high depressive and anxiety symptoms in (1) viremic WLWH, (2) aviremic WLWH, and (3) HIV-uninfected women [CES-D: (1) adjusted odds ratio (aOR) = 7.50, 95% confidence interval (CI): 4.10 to 13.7; (2) aOR = 4.54, 95% CI: 3.07 to 6.73; and (3) aOR = 6.03, 95% CI: 3.50 to 10.4; GAD-7: (1) aOR = 5.20; 95% CI: 2.60 to 10.4, (2) aOR = 6.03; 95% CI: 3.67 to 9.91, and (3) aOR = 6.24; 95% CI: 3.11 to 12.6]. CONCLUSIONS Poor sleep quality is highly prevalent, as is mental health symptom burden, among WLWH and HIV-uninfected controls. Future longitudinal studies are necessary to clarify the directionality of the relationship.
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Affiliation(s)
| | - Audrey L. French
- Department of Medicine, Stroger Hospital of Cook County, Chicago, IL
| | | | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Deborah Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences Medical Center, Brooklyn, NY
| | - Sushma K. Cribbs
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care & Sleep, Emory University, Department of Veterans Affairs, Atlanta, GA
| | - Deborah Jones Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Catalina Ramirez
- Department of Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Deborah Konkle-Parker
- Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS; and
| | - Seble Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC
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Backes A, Gupta T, Schmitz S, Fagherazzi G, van Hees V, Malisoux L. Advanced analytical methods to assess physical activity behavior using accelerometer time series: A scoping review. Scand J Med Sci Sports 2021; 32:18-44. [PMID: 34695249 PMCID: PMC9298329 DOI: 10.1111/sms.14085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
Physical activity (PA) is a complex human behavior, which implies that multiple dimensions need to be taken into account in order to reveal a complete picture of the PA behavior profile of an individual. This scoping review aimed to map advanced analytical methods and their summary variables, hereinafter referred to as wearable‐specific indicators of PA behavior (WIPAB), used to assess PA behavior. The strengths and limitations of those indicators as well as potential associations with certain health‐related factors were also investigated. Three databases (MEDLINE, Embase, and Web of Science) were screened for articles published in English between January 2010 and April 2020. Articles, which assessed the PA behavior, gathered objective measures of PA using tri‐axial accelerometers, and investigated WIPAB, were selected. All studies reporting WIPAB in the context of PA monitoring were synthesized and presented in four summary tables: study characteristics, details of the WIPAB, strengths, and limitations, and measures of association between those indicators and health‐related factors. In total, 7247 records were identified, of which 24 articles were included after assessing titles, abstracts, and full texts. Thirteen WIPAB were identified, which can be classified into three different categories specifically focusing on (1) the activity intensity distribution, (2) activity accumulation, and (3) the temporal correlation and regularity of the acceleration signal. Only five of the thirteen WIPAB identified in this review have been used in the literature so far to investigate the relationship between PA behavior and health, while they may provide useful additional information to the conventional PA variables.
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Affiliation(s)
- Anne Backes
- Physical Activity, Sport and Health Research Group, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Tripti Gupta
- Physical Activity, Sport and Health Research Group, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Susanne Schmitz
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Vincent van Hees
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Accelting, Almere, The Netherlands
| | - Laurent Malisoux
- Physical Activity, Sport and Health Research Group, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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Sleep, Prospective Memory, and Immune Status among People Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020438. [PMID: 33429860 PMCID: PMC7826879 DOI: 10.3390/ijerph18020438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 11/17/2022]
Abstract
Background: Persons living with HIV (PLWH) frequently report sleep complaints, but objective measurements are still lacking regarding sleep continuity, total sleep time per 24 h, and the links with both prospective memory performance and HIV infection parameters. Methods: PLWH (n = 96) and control (n = 96) groups (balanced for gender and age) were monitored by 24h-actigraphy for at least seven consecutive days. The prospective memory performance was assessed through a naturalistic, activity-based task performed twice a day on the actigraph. Results: PLWH had greater sleep latency and worse sleep continuity (higher fragmentation index) for night-time sleep and longest daytime nap (mean duration of the longest nap). Comparable results were reported for the prospective memory task; better performance scores were associated with several sleep parameters in controls but not in PLWH. Finally, within the PLWH group, being a long sleeper per 24 h (total sleep time > 8 h including more and long daytime naps) was associated with a greater severity of the disease (lower CD4 nadir and more frequent history of AIDS-defining events). Conclusions: These findings indicate that PLWH have more fragmented sleep and that the severity of HIV infection is associated with increased sleep duration.
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Abstract
Approximately 30-50% of persons living with HIV manifest some degree of neurocognitive impairment. Even mild-to-moderate forms of HIV-associated neurocognitive disorders (HAND) can result in difficulties with everyday functioning, such as suboptimal medication adherence and impaired driving. Despite the pervasive presence and consequences of HAND, there is a significant unmet need to develop effective behavioral strategies to reduce the incidence and consequences of HAND. Although there is an absence of evidence-based behavioral interventions specific to HAND, the literature reviewed in this chapter suggest the following modifiable lifestyle factors as intervention targets: physical activity, diet, sleep, and antiretroviral medication adherence. Adoption and maintenance of these healthy lifestyle factors may reduce inflammation and oxidative stress, which, in turn, may reduce the incidence and/or severity of HAND.
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Affiliation(s)
- Jessica L Montoya
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Brook Henry
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- HIV Neurobehavioral Research Program, San Diego, CA, USA.
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Hixon B, Burgess HJ, Wilson MP, MaWhinney S, Jankowski CM, Erlandson KM. A supervised exercise intervention fails to improve subjective and objective sleep measures among older adults with and without HIV. HIV Res Clin Pract 2020; 21:121-129. [PMID: 33119991 DOI: 10.1080/25787489.2020.1839708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Chronic sleep disruption can have significant negative health effects and prior studies suggest that people with HIV (PWH) have disproportionately higher rates of sleep problems. METHODS We evaluated baseline sleep of sedentary, older adults (50-75 years) with (n = 28) and without HIV (n = 29) recruited into a 24-week exercise study. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI); objective sleep parameters were assessed using wrist-worn actigraphy. Regression models were used to investigate changes in outcomes. RESULTS Fifty-seven participants completed the intervention. At baseline, PWH had significantly lower sleep efficiency (88.7 [95% CI 86, 91]%) compared to controls (91.8 [95% CI 91, 93]%; p = 0.02); other sleep measures indicated poorer sleep among PWH but did not reach statistical significance (p ≥ 0.12). Overall, sleep outcomes did not significantly change with the exercise intervention (all p > 0.05). In adjusted analyses, PWH demonstrated a decrease in total sleep time (-22.1 [-43.7, -0.05] p = 0.045) and sleep efficiency (-1.3 [-2.5, -.01], p = 0.03) during the 24 weeks of exercise; these differences were attenuated and no longer significant after adjusting for exercise intensity. At the completion of the intervention, compared to controls, PWH had significantly poorer sleep by PSQI score (2.2 [0.6, 3.8]; p = 0.006) and sleep efficiency (-2.8 [-5.4,-0.2]%; p = 0.04). CONCLUSIONS In this study, sleep disturbance was more prevalent in sedentary older PWH compared to uninfected controls. An exercise intervention had minimal effect on sleep impairments among PWH nor controls. Among older adults, interventions beyond cardiovascular and resistance exercise may be needed to significantly alter subjective and objective sleep outcomes.
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Affiliation(s)
- Brian Hixon
- University of Colorado, Colorado School of Public Health, Aurora, CO, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Melissa P Wilson
- Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
| | - Samantha MaWhinney
- Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
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Mengistu N, Belayneh Z, Shumye S. Knowledge, practice and correlates of sleep hygiene among people living with HIV/AIDS attending anti-retroviral therapy at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: a cross-sectional study. SLEEP SCIENCE AND PRACTICE 2020. [DOI: 10.1186/s41606-020-00044-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Sleep hygiene is a series of behavioral practices that can be performed by individuals with sleep complaints to prevent or reverse sleep difficulties. The feasibility, cost-effectiveness, absence of side effects and immediate responses to sleep problems make sleep hygiene practices more applicable than other treatment options for people living with HIV/AIDS. However, there is no evidence regarding sleep hygiene awareness and its practice in people with HIV/AIDS in Ethiopia.
Objectives
This study aimed to assess the knowledge, practice and correlates of sleep hygiene among adults attending outpatient anti-retroviral treatment at Zewditu Memorial Hospital.
Methods
This was an institutional based cross-sectional study conducted from 1st of May to 16th of June 2018 amongst people attending anti-retroviral therapy follow-up at Zewditu Memorial Hospital. Systematic random sampling technique was used to recruit a total of 396 study participants. Data were collected using interviewer-administered questionnaire. The Sleep Hygiene Index was used to measure the level of sleep hygiene of study participants. Binary logistic regression analysis was conducted to identify factors associated with sleep hygiene practice. In the multi-variable analysis, variables with P-values of less than 0.05 were considered as significant correlates of sleep hygiene practice with 95% confidence interval.
Results
The findings of this study showed that there are limitations regarding the knowledge and practice of sleep hygiene of people with HIV/AIDS in Ethiopia. None of the participants attended training regarding sleep hygiene. More than half (51.3%) had poor sleep hygiene practice. Female sex [AOR = 5.80:95% CI (3.12, 10.7)], being single [AOR =2.29:95% CI (0.13, 9.51)], depression [AOR = 2.93: 95% CI (1.73, 4.96)] and current khat use [AOR = 3.30; 95% CI (1.67, 6.50)] were identified as statistically significant correlates of poor sleep hygiene practice.
Conclusions
Knowledge regarding sleep hygiene is poor, and its practices are incorrect amongst people living with HIV/AIDS in Ethiopia. These findings demonstrate a need for professionals to play a major role in addressing this problem by integrating sleep hygiene as an added treatment modality to the HIV/AIDS care service. Designing training programs and awareness creation strategies for people with HIV/AIDS to improve their sleep hygiene practice is also highly recommended.
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Balthazar M, Diallo I, Pak VM. Metabolomics of sleep disorders in HIV: a narrative review. Sleep Breath 2020; 24:1333-1337. [PMID: 32198720 DOI: 10.1007/s11325-019-01993-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/25/2019] [Accepted: 12/03/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Sleep disturbances are prevalent among patients with human immunodeficiency virus (HIV), even those who are being treated on antiretroviral therapy. It is important to understand the metabolomic mechanisms underlying sleep disturbances among people living with HIV (PLWH). METHODS A review of recent literature was performed to explore the use of metabolomics in understanding sleep among PLWH. RESULTS We found only two studies that used metabolomics to explore sleep health among PLWH. CONCLUSION This paper reviews common sleep disorders in HIV, the existing metabolomic studies that may explain the relationship, and implications for future research. The use of metabolomics in exploring sleep disorders among PLWH will help to elucidate mechanistic links to improve patient outcomes.
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Affiliation(s)
- Monique Balthazar
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, 30322, USA
| | - Idiatou Diallo
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Victoria M Pak
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, 30322, USA.
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Ning C, Lin H, Chen X, Qiao X, Xu X, Xu X, Shen W, Liu X, He N, Ding Y. Cross-sectional comparison of various sleep disturbances among sex- and age-matched HIV-infected versus HIV-uninfected individuals in China. Sleep Med 2019; 65:18-25. [PMID: 31706188 DOI: 10.1016/j.sleep.2019.06.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/21/2019] [Accepted: 06/18/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE/BACKGROUND This study assessed the prevalence and correlates of various sleep disturbances in HIV-infected patients compared to sex- and age-frequency-matched HIV-uninfected controls in China. METHODS This cross-sectional analysis included 1469 HIV-infected cases and 2938 HIV-uninfected controls. Insomnia symptoms, poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] >5) as well as their specific domains, were assessed. RESULTS Prevalence of insomnia symptoms, poor sleep quality, and long sleep duration were higher in HIV-infected vs uninfected participants (23.7% vs 19.8%, 24.1% vs 19.9%, and16.1% vs 8.7%, respectively; all p < 0.05), and remained significant after adjusting for age, sex and education. An Age-stratified analysis showed that such differences were significant only at ages 18-29 and 30-44 years for insomnia symptoms and poor sleep quality long sleep duration was significant across all age groups. Among HIV-infected patients, multivariate analysis indicated that older age, depressive symptoms and frailty score were the most consistent variables associated with sleep disorders (ie, insomnia symptoms, poor sleep quality, short and long sleep durations), as well as all associations (if significant) were positive, excluding the negative associations of older age and depressive symptoms with short sleep duration. Regarding HIV-specific factors, only current CD4 cell count ≥500 cells/μL was negatively associated with insomnia symptoms. CONCLUSIONS The impact of HIV infection on sleep disturbances may differ across age groups and are more pronounced among young adults. Additionally, the phenomenon of prolonged sleep duration among HIV-infected patients should be noted, and its link to poor physical health warrants further investigation.
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Affiliation(s)
- Chenxi Ning
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Haijiang Lin
- Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China
| | - Xiaoxiao Chen
- Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China
| | - Xiaotong Qiao
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaohui Xu
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaoyi Xu
- Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China
| | - Weiwei Shen
- Taizhou City Center for Disease Control and Prevention, Taizhou City, Zhejiang Province, China
| | - Xing Liu
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Na He
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Yingying Ding
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
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Nogueira LFR, da Fonseca TC, Paterlini PH, Duarte ADS, Pellegrino P, Barros CRDS, Moreno CRDC, Marqueze EC. Influence of nutritional status and gastrointestinal symptoms on sleep quality in people living with HIV. Int J STD AIDS 2019; 30:885-890. [PMID: 31179887 DOI: 10.1177/0956462419846723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep problems are frequent among people living with HIV (PLWH). Recent studies have found that inadequate nutritional status and presence of gastrointestinal symptoms are associated with sleep problems. Therefore, the objective of the present study was to evaluate the influence of nutritional status and gastrointestinal symptoms on sleep quality in PLWH receiving antiretroviral therapy (ART). A cross-sectional study evaluating the influence of nutritional and gastrointestinal aspects on the quality of sleep in 307 PLWH (age ≥18 years) receiving ART seen at the Specialized Care Service of Santos (SP, Brazil) was carried out. The Pittsburgh Sleep Quality Index (PSQI), body mass index and three questions from the Self-Reporting Questionnaire (SRQ-20) were used. Generalized linear models adjusted for gender, age, time in use of antiretrovirals, viral load, CD4+ T-lymphocyte cell count and CD4/CD8 ratio were built. Results showed that body mass index did not affect sleep quality. However, the interaction between poor appetite and not having poor digestion and uncomfortable feelings in the stomach negatively influenced sleep quality. The interaction of the three symptoms evaluated also affected sleep quality. Gastrointestinal symptoms were associated with reduced sleep quality, but there was no influence of BMI. Although the etiology of this relationship is unclear, there seems to be an important association between sleep quality, immune function and gastrointestinal disorders.
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Affiliation(s)
| | - Thais Carvalho da Fonseca
- 1 Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
| | - Patrick Herman Paterlini
- 1 Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
| | - Adriana de Sousa Duarte
- 1 Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
| | - Pollyanna Pellegrino
- 1 Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
| | | | | | - Elaine Cristina Marqueze
- 1 Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
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Nogueira LFR, Pellegrino P, Duarte ADS, Inoue SRV, Marqueze EC. Transtornos Mentais Comuns estão associados a maior carga viral em Pessoas Vivendo com HIV. SAÚDE EM DEBATE 2019. [DOI: 10.1590/0103-1104201912114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O presente estudo teve como objetivo investigar a associação entre Transtornos Mentais Comuns (TMC) e carga viral de Pessoas Vivendo com Vírus da Imunodeficiência Humana - HIV (PVHIV) em seguimento clínico. Foi realizado um estudo transversal com 307 PVHIV com ≥ 18 anos de idade que estavam em terapia antirretroviral no Serviço de Assistência Especializada do município de Santos (SP) em 2016. A variável dependente de estudo foi a quantificação da carga viral; e a variável independente compreendeu os transtornos mentais comuns, avaliados pelo Self-Reporting Questionnaire (SRQ-20). Para comparação das médias das variáveis, foram realizados modelos lineares generalizados com nível de significância de 5%. Conclui-se que os TMC estão associados a uma maior carga viral entre PVHIV em seguimento clínico.
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14
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Wireless Physical Activity Monitor Use Among Adults Living With HIV: A Scoping Review. REHABILITATION ONCOLOGY 2019. [DOI: 10.1097/01.reo.0000000000000153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Buchanan DT, McCurry SM, Eilers K, Applin S, Williams ET, Voss JG. Brief Behavioral Treatment for Insomnia in Persons Living with HIV. Behav Sleep Med 2018; 16:244-258. [PMID: 27362814 DOI: 10.1080/15402002.2016.1188392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined the feasibility and preliminary efficacy of brief behavioral treatment for insomnia (BBTI) for persons living with HIV (PLWH). Of the 22 persons enrolled, 9 were lost before starting treatment, and one dropped out after starting BBTI. Acceptability was rated favorably by those completing the treatment (n = 12). The most common problems pertained to sleep hygiene: variable bedtimes and rise times, watching television, or consuming caffeine. Improvements on sleep outcomes at posttreatment were clinically and statistically significant on questionnaire and sleep diary outcomes. This study supports the overall feasibility of BBTI in PLWH, and the preliminary evidence supports further research on this treatment for PLWH who have insomnia, but dropouts indicate that some individuals may have difficulty initiating treatment.
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Affiliation(s)
- Diana Taibi Buchanan
- a Department of Biobehavioral Nursing and Health Systems, School of Nursing , University of Washington , Seattle , Washington , USA
| | - Susan M McCurry
- b Department of Psychosocial and Community Health, School of Nursing , University of Washington , Seattle , Washington , USA
| | - Kristi Eilers
- c Winder Clinic , Madigan Army Medical Center , Tacoma , Washington , USA
| | - Shauna Applin
- d Hilltop Family Medical Clinic , Community Health Care , Tacoma , Washington , USA
| | - Ellita T Williams
- a Department of Biobehavioral Nursing and Health Systems, School of Nursing , University of Washington , Seattle , Washington , USA
| | - Joachim G Voss
- e Frances Payne Bolton School of Nursing , Case Western Reserve University , Cleveland , Ohio , USA
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16
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Arbune M, Dumitru IM, Cretu-Stuparu M. Characteristics of sleep disorders in Romanian adults infected with human immunodeficiency virus. ARS MEDICA TOMITANA 2017. [DOI: 10.1515/arsm-2017-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Sleep disorders commonly occur in chronic diseases and are a great impairment on the quality of life. The current study aims to characterize the sleep problems of a group of Romanian HIV positive patients. A cross sectional study assessed sleep disorders by a series of self-report questionnaires: STOP-BANG, Epworth Sleep Questionnaire and Pittsburgh Sleep Quality Index. Demographic data, antiretroviral therapy, Lymphocytes CD4 levels were collected from medical records. Exclusion criteria were illiteracy, severe neurocognitive dysfunction and depression. We included 102 patients infected with human immunodeficiency virus, age between 22 and 50, sex ratio M/F=1.17. Reported conditions related to sleep disorders were: smoking (50%), hypertension (18%), obesity (6%) and snoring (7%). The STOP-BANG scale indicated 19% intermediate risk and 2% high risk of sleep apnea. According to Epworth score, daytime sleepiness was found in 18% of patients, 2% of them were dangerously sleepy. The average global score of Pittsburg Sleep Questionnaire is indicative of poor sleep quality in 42% cases. No correlation of sleep scores with antiretroviral regimens was found. Sleep problems with negative impact on daily functioning are frequent under age 50, in patients with human immunodeficiency virus. The management of chronic co-morbidities and psychological support should improve sleep disorders related to human immunodeficiency virus.
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Affiliation(s)
- Manuela Arbune
- Medical and Pharmaceutical Research Centre, Medicine and Pharmacy Faculty, "Dunarea de Jos" University from Galati, Galati , Romania
| | | | - Mariana Cretu-Stuparu
- Medical and Pharmaceutical Research Centre, Medicine and Pharmacy Faculty, "Dunarea de Jos" University from Galati, Galati , Romania
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17
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Lee KA, Gay C, Byun E, Lerdal A, Pullinger CR, Aouizerat BE. Circadian regulation gene polymorphisms are associated with sleep disruption and duration, and circadian phase and rhythm in adults with HIV. Chronobiol Int 2015; 32:1278-93. [PMID: 26512752 DOI: 10.3109/07420528.2015.1087021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Genes involved in circadian regulation, such as circadian locomotor output cycles kaput [CLOCK], cryptochrome [CRY1] and period [PER], have been associated with sleep outcomes in prior animal and human research. However, it is unclear whether polymorphisms in these genes are associated with the sleep disturbances commonly experienced by adults living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Thus, the purpose of this study was to describe polymorphisms in selected circadian genes that are associated with sleep duration or disruption as well as the sleep-wake rhythm strength and phase timing among adults living with HIV/AIDS. A convenience sample of 289 adults with HIV/AIDS was recruited from HIV clinics and community sites in the San Francisco Bay Area. A wrist actigraph was worn for 72 h on weekdays to estimate sleep duration or total sleep time (TST), sleep disruption or percentage of wake after sleep onset (WASO) and several circadian rhythm parameters: mesor, amplitude, the ratio of mesor to amplitude (circadian quotient), and 24-h autocorrelation. Circadian phase measures included clock time for peak activity (acrophase) from actigraphy movement data, and bed time and final wake time from actigraphy and self-report. Genotyping was conducted for polymorphisms in five candidate genes involved in circadian regulation: CLOCK, CRY1, PER1, PER2 and PER3. Demographic and clinical variables were evaluated as potential covariates. Interactions between genotype and HIV variables (i.e. viral load, years since HIV diagnosis) were also evaluated. Controlling for potentially confounding variables (e.g. race, gender, CD4+ T-cell count, waist circumference, medication use, smoking and depressive symptoms), CLOCK was associated with WASO, 24-h autocorrelation and objectively-measured bed time; CRY1 was associated with circadian quotient; PER1 was associated with mesor and self-reported habitual wake time; PER2 was associated with TST, mesor, circadian quotient, 24-h autocorrelation and bed and wake times; PER3 was associated with amplitude, 24-h autocorrelation, acrophase and bed and wake times. Most of the observed associations involved a significant interaction between genotype and HIV. In this chronic illness population, polymorphisms in several circadian genes were associated with measures of sleep disruption and timing. These findings extend the evidence for an association between genetic variability in circadian regulation and sleep outcomes to include the sleep-wake patterns experienced by adults living with HIV/AIDS. These results provide direction for future intervention research related to circadian sleep-wake behavior patterns.
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Affiliation(s)
- Kathryn A Lee
- a Department of Family Health Care Nursing , University of California at San Francisco , San Francisco , CA , USA
| | - Caryl Gay
- a Department of Family Health Care Nursing , University of California at San Francisco , San Francisco , CA , USA .,b Lovisenberg Diakonale Hospital , Oslo , Norway
| | - Eeeseung Byun
- a Department of Family Health Care Nursing , University of California at San Francisco , San Francisco , CA , USA
| | - Anners Lerdal
- b Lovisenberg Diakonale Hospital , Oslo , Norway .,c Department of Nursing Science , Faculty of Medicine, Institute of Health and Society, University of Oslo , Oslo , Norway
| | - Clive R Pullinger
- d Department of Physiological Nursing .,e Cardiovascular Research Institute , and
| | - Bradley E Aouizerat
- d Department of Physiological Nursing .,f Institute for Human Genetics, University of California at San Francisco , San Francisco , CA , USA
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18
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Helvig A, Wade S, Hunter-Eades L. Rest and the associated benefits in restorative sleep: a concept analysis. J Adv Nurs 2015; 72:62-72. [PMID: 26370516 DOI: 10.1111/jan.12807] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ashley Helvig
- Byrdine F. Lewis School of Nursing and Health Professions; Georgia State University; Atlanta Georgia USA
| | - Sonya Wade
- Byrdine F. Lewis School of Nursing and Health Professions; Georgia State University; Atlanta Georgia USA
| | - Lee Hunter-Eades
- Byrdine F. Lewis School of Nursing and Health Professions; Georgia State University; Atlanta Georgia USA
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19
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Taibi DM. Sleep disturbances in persons living with HIV. J Assoc Nurses AIDS Care 2013; 24:S72-85. [PMID: 23290379 DOI: 10.1016/j.jana.2012.10.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 10/27/2012] [Indexed: 12/16/2022]
Abstract
Up to 70% of persons living with HIV (PLWH) experience sleep disturbances. Insomnia and obstructive sleep apnea syndrome (OSAS) are common disorders seen in the primary care of PLWH. This paper reviews the current evidence and practice recommendations for treating these conditions. Insomnia is evaluated by clinical interview, questionnaires, and sleep diaries. The recommended first-line treatment is cognitive-behavioral therapy for insomnia (CBT-I) delivered by a trained therapist. Certain sedative medications may be useful, but over-the-counter treatments (particularly those containing antihistamines) are not recommended. OSAS is diagnosed by overnight sleep study but can be screened for in primary care. The STOP-BANG is a useful eight-item screening tool. The gold standard of treatment for OSAS is the use of a continuous positive airway pressure device. Treatment of insomnia and OSAS is important for improving quality of life and preventing associated health problems (especially cardiovascular disease in OSAS) in PLWH.
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Affiliation(s)
- Diana M Taibi
- Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington, USA
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Price CJ, Diana TM, Smith-Dijulio KL, Voss JG. Developing Compassionate Self-care Skills in Persons Living with HIV: a Pilot Study to Examine Mindful Awareness in Body-oriented Therapy Feasibility and Acceptability. Int J Ther Massage Bodywork 2013; 6:9-19. [PMID: 23730396 PMCID: PMC3666600 DOI: 10.3822/ijtmb.v6i2.197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Self-care skills for persons living with HIV (PLWH) are needed to better cope with the common symptoms and emotional challenges of living with this chronic illness. Purpose The purpose of this study was to examine the feasibility and acceptability of Mindful Awareness in Body-oriented Therapy (MABT) for individuals receiving medical management for HIV at an outpatient program. Setting A nonprofit outpatient day program that provided medical management to low-income individuals with HIV. Research Design A one group pre–post study design, nine participants were recruited to receive eight weekly MABT sessions of 1.25 hours each. Intervention MABT is designed to facilitate emotion regulation through teaching somatically-based self-care skills to respond to daily stressors. Main Outcome Measures To assess participant characteristics and study feasibility, a battery of health questionnaires and one week of wrist actigraphy was administered pre- and postintervention. A satisfaction survey and written questionnaire was administered postintervention to assess MABT acceptability. Results The results demonstrated recruitment and retention feasibility. The sample had psychological and physical health symptoms that are characteristic of PLWH. MABT acceptability was high, and participants perceived that they learned new mind-body self-care skills that improved HIV symptoms and their ability to manage symptoms. Conclusion The positive findings support a larger future study to examine MABT efficacy to improve coping with HIV symptoms among PLWH.
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Affiliation(s)
- Cynthia J Price
- Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA
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