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Esquivel-Mendoza JA, Satyanarayana S, Safren S, Rogers BG. Examining the Longitudinal Effects of Insomnia on Depression and Medication Adherence in People Living with HIV. Behav Sleep Med 2024:1-10. [PMID: 39066605 DOI: 10.1080/15402002.2024.2379340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
OBJECTIVE The management of HIV has shifted from a focus solely on the disease to a broader perspective encompassing co-occurring medical conditions and quality of life. Mental health concerns such as depression and sleep disturbances, particularly insomnia, are often overlooked in HIV care. The aim of the study was to investigate the longitudinal impact of insomnia on depression and medication adherence among (PLWH). METHODS This study, conducted in an urban HIV clinic, involved active patients and assessed depression, insomnia, and medication adherence at baseline, 3-month, and 6-month intervals. Hierarchical linear models were employed to analyze the fixed and random effects of time, within-person and between-person insomnia on depression, as well as the effects of time, within-person and between-person depression on ART adherence. RESULTS Within-person effects revealed that each one unit increase in the Insomnia Severity Index (ISI) was associated with a b = 0.267-point rise in Patient Health Questionnaire-9 (PHQ-9) scores (p < .001). Between-person effects revealed that each one-point increase in an individual's average ISI score was associated with a 0.476-point elevation in their PHQ-9 scores (p < .001). The between-person effects of depression on medication adherence indicated significance, with each point increase in an individual's average PHQ-9 score being linked to a 0.36% decrease in adherence (p = .012). CONCLUSION The study underscores the potential impact of insomnia on mental health and treatment adherence in people living with HIV (PLWH). This study emphasizes the necessity of comprehensive care models considering the interplay between sleep quality, mental health, and medication adherence for PLWH.
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Affiliation(s)
| | | | - Steven Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Brooke G Rogers
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
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Zhang H, Li Z, Li P, Fu G, Zhang D, Cheng X, Gao Y, Song W, Zhao H, Han M, Lv F, Wang L. Life expectancy and mental related burden of disease among people living with HIV/AIDS. AIDS Care 2024; 36:15-23. [PMID: 38526977 DOI: 10.1080/09540121.2024.2332444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
Mental health problems leads to serious disease burden among people living with HIV/AIDS (PLHIV). The study aimed at measuring the mental disorders-caused burden of disease based on PLHIV in mainland China. The data used was from the national HIV/AIDS case reporting system, life expectancy (LE) and LE-eliminated suicide were evaluated by the life-table method. The total YLLs and YLLs caused by suicide in each age group were calculated. The disability weights were estimated by the scale of depression symptoms (CES-D) from the multi-center cross-sectional survey, then calculated the corresponding YLDs as a burden of mental illness among PLHIV. Results showed that the LE had been prolonged by implementing antiviral therapy for PLHIV. The proportion of YLLs caused by suicide was the highest (5·46%) in the 15-24 age group. The YLDs in the 25-34 age group were the highest. The YLLs caused by suicide in males were higher than those in the same age group of females. The YLDs and YLLs were higher in heterosexual-infected PLHIV than in homosexual-infected PLHIV, except for YLLs in the 25-34 age group. In summary, this study first provided localized data on the disease burden caused by mental health problems among PLHIV.
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Affiliation(s)
- Hanxi Zhang
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
| | - Zheng Li
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
| | - Gengfeng Fu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Dongmin Zhang
- Xuchang Center for Disease Control and Prevention, Xuchang, People's Republic of China
| | - Xiaoli Cheng
- Anhui Provincial Center for Disease Control and Prevention, Hefei, People's Republic of China
| | - Yong Gao
- The first affiliated hospital of USTC, Anhui Provincial Hospital, Hefei, People's Republic of China
| | - Wei Song
- Shenyang Center for Disease Control and Prevention, Shenyang, People's Republic of China
| | - Hongxin Zhao
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Mengjie Han
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Fan Lv
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
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3
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Lee S, Oh JW, Park KM, Ahn JY, Lee S, Lee E. The prevalence and moderating factors of sleep disturbances in people living with HIV: a systematic review and meta-analysis. Sci Rep 2024; 14:14817. [PMID: 38937605 PMCID: PMC11211430 DOI: 10.1038/s41598-024-65713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
This systematic review and meta-analysis aimed to investigate the prevalence of self-reported sleep disturbances in people living with HIV considering the effects of age, depression, anxiety, CD4 cell counts, time since HIV diagnosis, study region, and the instruments used to measure sleep disturbances. We searched PubMed, PsycINFO, and EMBASE to include eligible articles. In this meta-analysis of 43 studies, the pooled prevalence of self-reported sleep disturbances was 52.29% (95% confidence interval 47.69-56.87). The subgroup analyses revealed that variations in the sleep measurements and study region significantly contributed to the observed heterogeneity. In the meta-regression analyses, higher proportions of participants with depression or anxiety and longer times since HIV diagnosis were significantly associated with a higher prevalence of self-reported sleep disturbances after adjusting for mean age. Our findings emphasise the substantial burden of sleep disturbances in people living with HIV and identified comorbid depression and anxiety and the time since HIV diagnosis as significant moderators. These results underscore the importance of considering these factors when designing tailored screening programmes for high-risk patients and implementing early interventions to prevent and mitigate sleep disturbances in people living with HIV.
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Affiliation(s)
- Suonaa Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jae Won Oh
- Department of Psychology, The University of Utah Asia Campus, Incheon, Republic of Korea
| | - Kyung Mee Park
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jin Young Ahn
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
| | - Eun Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
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Shorer EF, Rubin LH, French AL, Weber KM, Daubert E, Yohannes T, Morack R, Clish C, Bullock K, Gustafson D, Sharma A, Rogando AC, Qi Q, Burgess HJ, Dastgheyb RM. Tryptophan-kynurenine metabolic pathway and daytime dysfunction in women with HIV. J Neurovirol 2024:10.1007/s13365-024-01195-x. [PMID: 38472641 DOI: 10.1007/s13365-024-01195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
Sleep disturbances are prevalent in women with HIV (WWH). Tryptophan-kynurenine (T-K) pathway metabolites are associated with alterations in actigraphy derived sleep measures in WWH, although may not always correlate with functional impairment. We investigated the relationship between T-K pathway metabolites and self-reported daytime dysfunction in WWH and women without HIV (WWoH). 141 WWH on stable antiretroviral therapy and 140 demographically similar WWoH enrolled in the IDOze Study had targeted plasma T-K metabolites measured using liquid chromatography-tandem mass spectrometry. We utilized the daytime dysfunction component of the Pittsburgh Sleep Quality Index (PSQI) to assess functional impairment across HIV-serostatus. Lower levels of 5-hydroxytryptophan and serotonin were associated with greater daytime dysfunction in all women. In WWH, daytime dysfunction was associated with increased kynurenic acid (R = 0.26, p < 0.05), and kynurenic acid-tryptophan (KA-T) ratio (R = 0.28, p < 0.01). WWH with daytime dysfunction had a 0.7 log fold increase in kynurenic acid compared to WWH without daytime dysfunction. Kynurenic acid levels and the KA-T ratio were associated with daytime dysfunction in WWH but not in WWoH. Longitudinal studies are needed to establish a causal relationship and directionality between T-K metabolic changes and sleep impairment in WWH.
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Affiliation(s)
- Eran Frank Shorer
- Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Room 490, Carnegie Building, 600 North Wolfe Street, Baltimore, MD, USA.
| | - Leah H Rubin
- Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Room 490, Carnegie Building, 600 North Wolfe Street, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Audrey L French
- Department of Medicine, Stroger Hospital of Cook County, Chicago, IL, USA
| | | | | | | | | | - Clary Clish
- Metabolomics Platform, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Kevin Bullock
- Metabolomics Platform, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Deborah Gustafson
- Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrea C Rogando
- Hektoen Institute of Medicine, Chicago, IL, USA
- College of Science and Health at Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Raha M Dastgheyb
- Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Room 490, Carnegie Building, 600 North Wolfe Street, Baltimore, MD, USA
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Skogen V, Langseth R, Rohde GE, Rysstad O, Sørlie T, Lie B. Prevalence of mental distress and factors associated with symptoms of major depression among people living with HIV in Norway. AIDS Care 2024; 36:173-180. [PMID: 37909108 DOI: 10.1080/09540121.2023.2275043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
For people living with HIV (PLHIV) who can access lifesaving treatment, HIV has become a chronic lifelong condition; however, PLHIV have more mental and somatic comorbidities than their HIV-negative peers. In this cross-sectional study, we assessed the prevalence of mental distress and identified factors associated with major depression among 244 well-treated PLHIV residing in Norway. Participants completed validated questionnaires covering mental and somatic health. The prevalence of mental distress, defined as a score on the Hopkins Symptom Check List-25 >1.75, was 32%, and that of symptoms of major depression, defined as a score on the Beck Depression Inventory-II ≥20, was 15%. The factors associated with major depressive symptoms identified using logistic regression were risk of drug abuse (adjusted odds ratio (AOR) 15.1, 95% confidence interval (CI) 3.28, 69.3), fatigue (AOR 12.5, 95% CI 3.90, 40.0), trouble sleeping (AOR 7.90, 95% CI 2.85, 21.9), African origin (AOR 3.90, 95% CI 1.28, 11.9), low education (AOR 3.31, 95% CI 1.18, 9.30), and non-disclosure (AOR 3.22, 95% CI 1.04, 10.0). Our findings indicate that the prevalence rates of mental distress and major depressive symptoms are higher among well-treated PLHIV residing in Norway than in the general population. These conditions are under-diagnosed and under-treated, and increased awareness is needed.
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Affiliation(s)
- Vegard Skogen
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
| | - Ranveig Langseth
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
| | - Gudrun E Rohde
- Department of Clinical Research, Hospital of Southern Norway, Kristiansand, Norway
- Faculty of Health & Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ole Rysstad
- Department of Internal Medicine, Hospital of Southern Norway, Kristiansand, Norway
| | - Tore Sørlie
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
- Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromso, Norway
| | - Birgit Lie
- Department of Psychosomatic and Trauma, Hospital of Southern Norway, Kristiansand, Norway
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Yuan GF, Qiao S, Li X, Zhou Y, Shen Z. Psychological Mechanisms of Internalized HIV Stigma Affect Sleep Impairment among People Living with HIV in China: A follow-up Study. AIDS Behav 2024; 28:439-449. [PMID: 38048016 DOI: 10.1007/s10461-023-04236-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
Prior studies have demonstrated that HIV-related stigma (e.g., internalized HIV stigma) is detrimental to the physical and mental health (e.g., sleep impairment and depressive symptoms) of people living with HIV (PLWH). However, follow-up data are limited regarding the longitudinal relationships between internalized HIV stigma, future orientation, self-esteem, depressive symptoms, and sleep impairment. The present study attempted to examine a mediation model involving these variables among Chinese PLWH. A two-wave follow-up design (6 months intervals) was employed in a final sample of 1,140 Chinese PLWH (Mage = 41.63, SD = 9.29, age range: 21-67 years; 64.6% men). Participants completed Internalized HIV Stigma Scale, Optimism About the Future Scale, Rosenberg Self-Esteem Scale, Center of Epidemiological Studies Depression Scale, and an adapted version of Pittsburgh Sleep Quality Index. Results revealed that internalized HIV stigma at baseline had a significant direct relationship with sleep impairment over time, and a significant indirect relationship with increased sleep impairment over time via future orientation and depressive symptoms. Furthermore, the linkage between internalized HIV stigma and sleep impairment was serially mediated via self-esteem and depressive symptoms. This study highlights the deleterious effects of internalized HIV stigma on the physical and psychological health of PLWH. The findings suggest that interventions targeting internalized HIV stigma and related factors such as future orientation, self-esteem, and depressive symptoms may facilitate improvements in sleep quality and overall well-being among PLWH.
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Affiliation(s)
- Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, Leshan, Sichuan, China.
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
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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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Zhou Q, Yang L, Wan Y, Li X, Zhu Z, Wang J, Huang J, Shen F, Tan Q, Dong L, Ni Q, Zhang S, Fu Y. Gender differences in symptom burden among people living with HIV/AIDS receiving antiretroviral therapy in Yunnan, China. AIDS Care 2024:1-11. [PMID: 38176025 DOI: 10.1080/09540121.2023.2300978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
ABSTRACTLittle is known about gender differences in the symptom burden of people living with HIV/AIDS (PLWHA) on antiretroviral therapy in China. This study was conducted based on a biopsychosocial-medical model to describe gender differences in symptom burden among 1035 PLWHA in Yunnan Province, China. After propensity score matching, 798 PLWHA were included in this analysis. Feeling stressed, poor sleep, and memory loss were the most burdensome symptoms among men, while feeling stressed, memory loss, and dizziness were the most burdensome symptoms among women. Among men PLWHA, factors associated with symptom burden were being of the ethnic minority, CD4 count ≥ 500 cells/mm3, physical functioning, and social support. Among women PLWHA, factors associated with symptom burden were being an inpatient, physical functioning, psychological functioning, and social support. Our findings suggest that healthcare providers need to take into account gender differences when developing optimal prevention, treatment, and care programs that provide individualized care to reduce patients' symptom burden.
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Affiliation(s)
- Qiao Zhou
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Liying Yang
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Yu Wan
- Cardiothoracic surgery, The Second People's Hospital of Yibin, Yibin, People's Republic of China
| | - Xucheng Li
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Jianhua Wang
- Department of Oncology, The First Affiliated Hospital of Dali University, Dali, People's Republic of China
| | - Jibiao Huang
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Fang Shen
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Qiu Tan
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Liting Dong
- Thyroid and breast surgery, The First Affiliated Hospital of Air Force Medical University, Xian, People's Republic of China
| | - Qinmin Ni
- School of Health Science and Technology, West Yunnan University of Applied Technology, Dali, People's Republic of China
| | - Shixiao Zhang
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Yanfen Fu
- School of Nursing, Dali University, Dali, People's Republic of China
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Reisert H, Miner B, Farhadian S. Sleep deficiency among people living with human immunodeficiency virus: A growing challenge. HIV Med 2024; 25:5-15. [PMID: 37485570 PMCID: PMC10803648 DOI: 10.1111/hiv.13526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE OF REVIEW The purpose of this narrative review is to consolidate and summarize the existing literature on sleep deficiency among people living with human immunodeficiency virus (HIV; PLWH), to discuss the potential impact of antiretroviral therapy on sleep deficiency and to identify priorities for future research in this area. RECENT FINDINGS Three important domains of sleep deficiency include alterations in sleep quality (including sleep disorders), duration and timing. The existing HIV and sleep deficiency literature, which is robust for sleep quality but sparser for sleep duration or sleep timing, has identified epidemiological correlates and outcomes associated with sleep deficiency including sociodemographic factors, HIV-specific factors, aspects of physical and mental health and cognition. SUMMARY Sleep deficiency is a common problem among PLWH and is likely underdiagnosed, although more high-quality research is needed in this area. Sleep quality has received the most attention in the literature via methodologies that assess subjective/self-reported sleep quality, objective sleep quality or both. There is significantly less research on sleep duration and minimal research on sleep timing. Use of certain antiretroviral therapy drugs may be associated with sleep deficiency for some individuals. Future research should utilize larger, longitudinal studies with consistent, comprehensive and validated methods to assess both subjective and objective measures of sleep deficiency to better understand the prevalence, correlates and clinical implications of sleep deficiency in PLWH.
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Affiliation(s)
- Hailey Reisert
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Brienne Miner
- Yale School of Medicine, Section of Geriatrics, New Haven, CT, USA
| | - Shelli Farhadian
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
- Yale School of Medicine, Department of Neurology, New Haven, CT, USA
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, USA
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Abstract
PURPOSE OF REVIEW To highlight recent publications about sleep disorders and sleep health in adult persons with HIV (PWH), with a focus on how sleep relates to comorbidities in PWH. RECENT FINDINGS Sleep disorders are more common in PWH than in seronegative controls, especially insomnia, with four different recent studies estimating insomnia prevalence in PWH at 21-35%. Sleep apnea prevalence estimates in PWH have varied widely. Most studies suggest PWH do not have higher sleep apnea prevalence compared with controls, though definitions of sleep apnea may affect these analyses. Comorbidities recently associated with sleep in PWH include myocardial infraction (insomnia), depressive symptoms (insomnia and restless legs syndrome), and pain (insomnia). Cognition associations with sleep were inconsistent and may depend on data collection and analytic methods. Sleep health dimensions are uncommonly reported, but PWH appear to report worse sleep health dimensions and these demonstrated mixed associations with cognition and depressive symptoms in recent studies. SUMMARY Sleep disorders and poor sleep health are common in PWH and are related to comorbidities. More data from longitudinal studies and clinical trials are needed. Clinical trials of insomnia interventions in PWH are especially warranted.
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Affiliation(s)
- Ken M Kunisaki
- Minneapolis Veterans Affairs Healthcare System
- University of Minnesota, Minneapolis, Minnesota, USA
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Legas G, Beyene GM, Asnakew S, Belete A, Desie T. Poor sleep quality and associated factors among HIV-positive pregnant women in Northwest, Ethiopia: a facility-based, cross-sectional study. BMC Psychiatry 2022; 22:559. [PMID: 35986312 PMCID: PMC9389670 DOI: 10.1186/s12888-022-04209-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Poor sleep quality during pregnancy might have an impact on adverse birth outcomes like premature rupture of membrane, preterm birth, lifelong neurocognitive impairment, low birth weight, and increased the risk of neonatal morbidity and mortality. In Ethiopia, the magnitude of poor sleep quality among this group of people is extremely limited. So, this study aims to determine the magnitude of poor sleep quality and its associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia. METHODS An institution-based cross-sectional study was done using a simple random sampling technique to recruit 411 HIV-positive pregnant women from January to March; 2021. Sleep quality over the last 1 month was measured using the Pittsburgh Sleep Quality Index (PSQI). General anxiety disorder (GAD-7), Sleep Hygiene Index (SHI), and List of Threatening of Experiences (LTE) instruments were used to identify factors associated with poor sleep quality. Bivariate and multivariable logistic regression with odds ratio and 95% CI were employed to identify determinant factors of poor sleep quality. Statistical significance association was declared at P-value < 0.05. RESULTS A total of 411 out of 423 HIV-positive pregnant women were interviewed, with a response rate of 97.1%. The overall magnitude of poor sleep quality among HIV-positive pregnant was found to be 39.4% with a 95% of confidence interval (CI) (34.3, 44.3). Stressful life events, [AOR = 3.10, 95% CI (1.60, 6.01)], having comorbid general anxiety symptoms [AOR = 2.46, 95% CI (1.58, 3.81)], unplanned pregnancy [AOR = 2.18, 95% CI (1.20, 3.96)], and poor sleep hygiene practice [AOR = 2.23, 95% CI (1.21, 4.10)] were significantly associated with poor quality of sleep. CONCLUSION The overall magnitude of poor sleep quality among HIV-positive pregnant women was high. Stressful life events, poor sleep hygiene, unplanned pregnancy, and comorbid general anxiety symptoms were the determinant factors of poor sleep quality that should be taken high consideration for early detection and appropriate intervention for poor sleep quality in HIV-positive pregnant women.
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Affiliation(s)
- Getasew Legas
- Department of Psychiatry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Getnet Mihretie Beyene
- grid.510430.3Department of Psychiatry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- grid.510430.3Department of Psychiatry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- grid.510430.3Department of Psychiatry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Desie
- grid.510430.3Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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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] [Key Words] [Grants] [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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