Original Research: Quality of Sleep among Hypertensive Patients in a Semi-Urban Nigerian Community: A Prospective Study

Effect of Om chanting and Yoga Nidra on depression anxiety stress, sleep quality and autonomic functions of hypertensive subjects - a randomized controlled trial

INTRODUCTION

Hypertension (HTN) is a common and growing public health challenge with severe risk factors. Hence, this study aimed to assess the effect of Om chanting and Yoga Nidra on depression, anxiety, stress, sleep quality and autonomic functions on individuals with hypertension.

METHODS

This prospective randomized controlled study was conducted in patients with hypertension at Little Flower Medical Research Center. A total of 80 patients with diagnosed hypertension were recruited and randomized equally to either the experimental group or control group. The experimental group received a combination of Om chanting and Yoga Nidra for five days a week for two months. The control group participants continued with their regular conventional medications. Depression anxiety stress scale (DASS), Pittsburgh sleep quality index (PSQI) and heart rate variability (HRV) scores were assessed at baseline, 30 and 60 day for both the groups.

RESULTS

A total of 34 subjects in the experimental group and 31 subjects in the control group were included in the analysis. There was a significant (p<0.001) reduction in depression, anxiety, stress, and a significant (p<0.001) improvement in PSQI and HRV parameters in the experimental group was observed as compared to the control group. No adverse events were reported during the trial period.

CONCLUSIONS

The current study validates the effectiveness of Om chanting and Yoga Nidra in reducing depression, anxiety, stress and improving sleep quality and autonomic functions in hypertensive patients. These interventions could thus be considered a safer form of complementary therapy in managing stress and hypertension.

Sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia

Introduction

Sleep plays an essential role in every individual’s life since it contributes greatly to their well-being and health. Poor sleep quality is one of the most common consequences of hypertension (HTN), which is a leading public health problem. In Ethiopia, it is the main health concern among hypertension patients. Thus, in the study area, there is limited information regarding the investigation of sleep quality among hypertension patients. Therefore, this study aimed to assess sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted among adult HTN patients from March 15/2021 to May 15/2021 in Northwest Amhara Regional State Referral Hospitals. A systematic random sampling method was used to select the study participants. A face-to-face interviewer-administered questionnaire with chart review was used. The Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality was used in this study. A binary logistic regression was used to see the association between dependent and independent variables. Variables having a p-value < 0.05 with a 95% CI were considered statistically significant in the multivariable logistic regression analysis.

Results

In this study, 563 hypertensive patients were included, with a response rate of 96.9%. The overall prevalence of poor sleep quality was 37.7% (95% CI: 33.4%–41.6%). Female gender (AOR = 2.55, 95% CI: 1.55–4.18), age ≥ 65 years (AOR = 4.07, 95% CI: 2.07–7.97), overweight (BMI) ≥ 25 kg/m2 (AOR = 1.68, 95% CI: 1.06–2.65), WHO stage II hypertension (AOR = 1.78, 95% CI:1.01–3.12), poor physical activity (AOR = 2.39, 95% CI:1.41–4.05), participants who had depression (AOR = 2.03,95% CI:1.24–3.34) and participants who had anxiety (AOR = 1.89, 95% CI: 1.16–3.03) were factors associated with poor sleep quality.

Conclusions

In this study, more than one-third of the study participants had poor sleep quality. Female gender, age ≥ 65 years, overweight (BMI) ≥ 25 kg/m2, stage II hypertension, physical inactivity, depression, and anxiety were all associated with poor sleep quality. Managing depression and anxiety disorders, encouraging physical activity, and providing health education about weight loss are all necessary for HTN patients.

A Comparative Study of Baseline Heart Rate Variability, Sleep Quality, and Oxidative Stress Levels in Hypertensive Versus Normotensive Subjects: A Cross-Sectional Study

Objectives: To understand sleep quality, oxidative stress levels, and heart rate variability (HRV) in subjects with hypertension. This study aims to create baseline data in hypertensive subjects to research the possibility of further estimating the risk of developing cardiovascular mortality and morbidity in a patient with hypertension.

Design and methods: This analytical cross-sectional study, encompassing 128 study subjects of both genders, with 64 hypertensive subjects, analyse the co-relation of sleep quality, malondialdehyde, and heart rate variability in hypertensive and normotensive subjects. The study was done in a tertiary teaching institute in northern India for 14 months. Descriptive statistics were used, and the independent t-test, Mann-Whitney U test, and Chi-square were used to find the association among the variables. Linear regression was used to estimate the effect of blood pressure on malondialdehyde levels.

Results: Subjects with hypertension were found to have poor sleep quality (Global PSQI score ≥5, p=0.0001) and an increased malondialdehyde level (0.30303±0.17193 µM/L, p=0.0001). The hypertensive subjects were found to have lower parasympathetic activity as indicated by low high frequency (2.79463±473.220280; p=0.0001) and increased sympathetic activity; low frequency/high frequency (2.29823±2.792441; p=0.0001). Multivariate linear regression predicts that with one unit increase in systolic blood pressure, the malondialdehyde level increases by 0.006 units (p=0.002; 95% CI).

Conclusion: Among the hypertensive group, there is significantly increased oxidative stress level, poor quality of sleep, and increased sympathetic activity, thereby predisposing the subjects to increased risk of cardiac morbidity and mortality.

Clinical and Genetic Factors Associated With the Breast Cancer-Related Sleep Disorders: The "CAGE-Sleep" Study-A Cross-Sectional Study

CONTEXT

Despite being among the most reported concerns in breast cancer patients, sleep disturbances are still poorly assessed and managed in routine clinical practice. Correctly evaluating these symptoms and understanding the underlying clinical and genetic factors would help medical teams develop an adequate treatment strategy for each patient.

OBJECTIVES

1) To explore the severity of insomnia as well as sleep quality in a sample of Lebanese women with breast cancer undergoing chemotherapy; 2) To examine the correlation between sociodemographic, clinical, psychiatric (anxiety and depression), genetic factors, and alterations in sleep patterns.

METHODS

A cross-sectional study was carried out using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) (December 2017-June 2019; Ethical reference number: CEHDF1016). All patients gave their written consent and were genotyped for several polymorphisms in CLOCK, CRY2, PER2, COMT, DRD2, OPRM1, and ABCB1 genes using Lightcycler® (Roche).

RESULTS

Our sample included a total of 112 women. Almost half of the patients reported insomnia problems (with 20.5% moderate insomnia and 7.1% severe insomnia). Multivariable analyses taking the PSQI score as the dependent variable, showed that higher depression score and dyslipidemia (yes versus no) were significantly associated with higher PSQI scores (worse sleep quality), whereas having the DRD2 CT genotype versus CC and a higher chemotherapy cycle number were significantly associated with lower PSQI scores (better sleep quality). Depression was also significantly associated with higher ISI scores. When forcing all the genes in each model, the results remained the same except for depression that has been replaced by anxiety in the multivariable analysis.

CONCLUSION

Our study confirms the relationship between anxiety/depression, cycle number, dyslipidemia and DRD2 polymorphism with insomnia and highlights the importance of treating all associated factors to improve the overall QOL of patients.

A survey assessing sleep efficiency among Saudis during COVID-19 home confinement using the Pittsburgh sleep quality index: A call for health education

The COVID-19 pandemic has introduced uncertainties that have disrupted regular routines. Sleep may be adversely affected by stressful circumstances that jeopardize general health. Hence, the impact of home confinement on the sleep efficiency of the general population was assessed.

An online survey was conducted by using the Pittsburgh sleep quality index (PSQI) to assess sleep duration, sleep efficiency, latency to fall asleep, and global PSQI score. Questions pertaining to demography, home confinement, and anxiety were included. Data was collected from the residents of the Southwestern region from April 15, 2020 to May 15, 2020. Data were analyzed through bivariate, multivariate logistic regression, and independent t tests.

A total of 593 subjects responded to the survey. Males (OR 1.92 [1.3–2.7], p < 0.001), and subjects aged ≥51 years (OR 2.49 [1.3–4.4], p = 0.002) were more likely to be poor sleepers (<6 h). In hypertensive subjects, inadequate sleep was twice as high (OR 2.2 [1.1–4.4], p < 0.05) than other comorbidities. Males were less likely to have sleep latency (OR 0.58 [0.40–0.86], p = 0.005) but smoking increased the latency of falling asleep (OR 2.41 [1.47–4.0], p < 0.001). Sleep duration was significantly influenced by home confinement (p = 0.002), whereas sleep duration (p = 0.001), latency (p = 0.018), sleep efficiency (p = 0.005), and global PSQI scores (p = 0.005) were significantly affected by anxiety.

In the southwestern region, we found sleep influenced by anxiety about COVID-19. Community pharmacists are the most accessible health care professionals and could play a pivotal role in educating the lay public on the importance of sleep hygiene through posters displayed in pharmacies and with the help of public education material.

Subjective Poor Sleep Quality is Associated with Higher Blood Pressure and Prevalent Hypertension in General Population Independent of Sleep Disordered Breathing

OBJECTIVE

To explore the relationship of subjective sleep quality with blood pressure (BP) and hypertension by considering the influence of sleep disordered breathing (SDB) and age in the general population.

METHODS

We evaluated sleep quality using the Pittsburgh sleep quality index (PSQI) and SDB using NoSAS score and measured BP in randomly selected adults in China in 2019. Sleep quality is categorized into four groups as very good, fairly good, fairly bad and very bad. SDB is defined as NoSAS score ≥8. Hypertension is defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, and/or use of antihypertensive medicine within previous 2 weeks. Multi-variable linear and logistic regression analyses were used to assess the association of global PSQI score and sleep quality with BP and prevalent hypertension.

RESULTS

In the 33,341 participants (53.4% women, median age: 48 years), prevalence of hypertension significantly increased from very good to very bad sleepers in total (34.3 vs 42.6 vs 50.3 vs 58.5%), SDB (61.2 vs 68.3 vs 73.3 vs 75.5%) and non-SDB participants (26.8 vs 33.1 vs 40.1 vs 50.9%). In multiple linear regression, PSQI global score showed significant positive association with BP levels in total, SDB and non-SDB participants, consistent in sensitivity analysis by excluding participants who were taking antihypertensives, and in participants aged <60 years in age-stratified analysis. In multivariable logistic regression, odds ratio for presence of hypertension significantly increased from very good to very bad sleepers in total (1 vs 1.08 vs 1.22 vs 1.48), SDB (1 vs 1.17 vs 1.35 vs 1.28) and non-SDB participants (1 vs 1.05 vs 1.14 vs 1.53), consistent in participants aged <60 years.

CONCLUSION

Poor subjective sleep quality is significantly associated with higher BP and prevalent hypertension, independent of SDB in the young- and middle-aged general population, indicating potential of improving sleep quality to lower BP and optimize hypertension management at population level.

Prevalence of poor sleep quality and its associated factors among hypertensive patients on follow up at Jimma University Medical Center

Several studies have reported an association between the abnormal duration of sleep and chronic conditions including hypertension. However, the existing body of evidence is not entirely significant; as insignificant associations between poor sleep and blood pressure (BP) have been found across different studies. The aim of this study was to determine prevalence and factors associated with poor sleep quality among hypertensive patients in Jimma University Medical Center. An institution based cross sectional study design was employed from June 01 to July 15, 2018 among 279 hypertensive patients on follow-up at Jimma University Medical Centre chronic clinic, Jimma, Ethiopia. Data collection was done by using face to face interview. Sleep quality was measured by using validated, standard Pittsburgh sleep quality index (PSQI). PSQI total score ≥5 was considered as a diagnostic of poor sleep quality. On multivariate logistic regression variables with of p value of <0.05 was considered as predictors of poor sleep quality. A total of 279 hypertensive patients were enrolled into the study. Out of which 279, 142 (50.9%) were males. The prevalence of poor sleep quality among hypertensive patient was 99 (35.5%). Physical inactivity (AOR = 0.288, 95% CI: (0.130-0.639), diastolic blood pressure Stage I (AOR = 3.923, 95% CI: 1.052-14.632) and diastolic blood pressure Stage II (AOR = 4.520; 95% CI: 1.079-18.931) were identified as independent predictors of poor sleep quality. In conclusion, about one-third of hypertensive patients were poor sleepers. High diastolic blood pressure and physical inactivity are independent predictors of poor sleep quality among hypertensive patients.

The Relationship Between Quality of Sleep and Quality of Life of Patients in Medan, Indonesia

BACKGROUND

Hypertension is one of the most common diseases around the world, which is the most risk factor related to cardiovascular disease. The quality of life of hypertensive patients is influenced by various factors, namely age, sex, educational background, ethnicity and nutritional status. Another factor that is also important is the quality of sleep.

AIM

We aimed the assessment of sleep quality using a PSQI questionnaire, and quality of life assessment with the SF-36 questionnaire.

METHODS

This study was a cross-sectional study of 45 respondents at the H. Adam Malik Central General Hospital in Medan in 2018. Assessment of sleep quality was performed through the PSQI questionnaire (Pittsburgh Sleep Quality Index), and quality of life assessment was carried out with the SF-36 questionnaire.

RESULTS

The prevalence of impaired sleep quality in hypertensive patients was 35.6%. Most patients have a good quality of life, with 71.1%. In this study, sleep quality was found to be related to the quality of life (p = 0.037). Furthermore, variables related to sleep quality were sex (gender) (p = 0.003) and education (p = 0.005). In multivariate analysis, the quality of life is predominantly influenced by sleep quality (p = 0.025).

CONCLUSION

The quality of life of hypertensive patients is influenced by the quality of sleep.

The relationship between sleep disturbances and quality of life in elderly patients with hypertension

Purpose

Sleep disorders, such as insomnia with objective short sleep duration, are associated with increased risk of hypertension. The objective of the study was to evaluate the effects of insomnia and daytime sleepiness on the quality of life (QOL) among elderly hypertensive patients.

Patients and methods

This cross-sectional study covered 100 patients with hypertension. All participants completed standardized questionnaires, such as the Epworth Sleepiness Scale (ESS), the Athens Insomnia Scale (AIS), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF), and clinical data were obtained from patients' medical records.

Results

We showed that more than half of the patients experienced insomnia (AIS score ≥6) and 39% experienced daytime sleepiness. Daytime sleepiness was negatively associated with perceived QOL (r=-0.478, P<0.001). It was also shown that insomnia might be influenced by older age (P<0.001), occupational activity (P=0.011), overweight (body mass index [BMI] 25-30) (P=0.042), and longer duration of illness (P=0.049) among hypertensive patients.

Conclusion

Sleep problems have a significant negative impact on the QOL in patients with hypertension, especially in the physical domain of the QOL questionnaire. The occurrence of sleep problems in patients with hypertension is influenced by older age, primary education, overweight, occupational activity, and longer duration of illness.

Subjective sleep quality, blood pressure, and hypertension: a meta-analysis

Sleep quality is an important aspect of sleep, but no meta-analysis has elucidated its relationship with blood pressure (BP) and hypertension. A meta-analysis was conducted in October 2016 using multiple databases, including Embase and Medline. Studies that assessed subjective sleep quality and BP or hypertension were included. Upon full-text evaluation, 29 articles from 45 041 patients were selected, of which 22 articles were included in the meta-analysis and seven were presented narratively. Poor sleep quality was significantly associated with a greater likelihood of hypertension (odds ratio, 1.48; P value = .01). Poor sleepers had higher average systolic BP (mean difference = 4.37, P value = .09) and diastolic BP (mean difference = 1.25, P value = .32) than normal sleepers without statistical significance. Patients with hypertension had significantly worse sleep quality scores (mean difference = 1.51, P value < .01), while BP dippers had significantly better scores (mean difference = -1.67, P value < .01). The findings highlight the relationship between sleep quality and hypertension.

The relationship between hypertension and nocturnal waking in community-dwelling elderly individuals

AIM

This study aimed to clarify the relationship between hypertension and nocturnal waking among community-dwelling elderly individuals.

SUBJECTS AND METHODS

The survey was performed by asking questions related to the basic attributes, lifestyle, sleep conditions and the health status of 422 elderly individuals who belonged to elderly clubs. The subjects were divided into a hypertension group and a non-hypertension group. The data were analyzed using Spearman's rank correlation coefficient and a logistic regression analysis.

RESULTS

Two hundred of the 422 elderly individuals responded to the questions (response rate: 47.4%). The rate of obesity in the hypertension group was significantly higher (p=.01) than that in the non-hypertension group. The logistic regression analysis revealed that hypertension was associated with the BMI (OR=1.148, 95%CI: 1.022-1.289) and the number of nocturnal waking episodes (OR=1.449, 95%CI: 1.015-2.067). In the hypertension group, the number of nocturnal waking episodes was significantly correlated with age (rs=0.232), and the performance of volunteer activities was associated with a decreased number of nocturnal waking episodes (rs=-0.356).

CONCLUSIONS

It was shown that nocturnal waking and obesity were strongly associated with hypertension. The performance of volunteer activities was also correlated a decrease in the number of nocturnal waking episodes. Further studies should be performed to investigate the relationship between hypertension, the number of nocturnal waking episodes and sympathetic nerve activity. A greater number of physiological activities should be evaluated and the volunteer activities in which the elderly people participated should be precisely analyzed.

Sleep Quality and Associated Factors in Older Turkish Adults With Hypertension: A Pilot Study

PURPOSE

The purpose of this study was to evaluate sleep quality and to explore its associations with participant characteristics, anemia, excessive daytime sleepiness, and physical activity in older Turkish adults with hypertension.

METHOD

This cross-sectional study included 128 adults aged 60 years or older with hypertension. Data were collected by using a personal information form, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the International Physical Activity Questionnaire. Anemia was assessed by hemoglobin levels.

RESULTS

Eighty-one patients (63.3%) reported poor sleep quality. Anemia was present in 35.2% of the patients (defined as hemoglobin <13 g/dL for males and <12 g/dL for females). Female gender, the presence of anemia, and low levels of physical activity were associated with poor sleep quality. Conclusion/Implication: The majority of the participants had poor sleep quality. Better understanding of risk factors associated with poor sleep quality may contribute to more effective interventions to improve health and well-being.

Sleep quality among primary care attendees in Kaduna, Northern Nigeria: a case-control study

OBJECTIVE

To assess sleep quality and its determinants among primary care patients in a Northern Nigerian setting.

METHODS

We administered the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale to 217 consecutive patients attending the General Outpatient Clinic of Barau Dikko Specialist Hospital, Kaduna, and PSQI to 223 age-matched controls to evaluate their sleep quality and levels of anxiety and depression. A data collection sheet was used to record the sociodemographic characteristics of patients and controls, and the clinical characteristics of the patients.

RESULTS

The mean ages of all the subjects, patients, and controls were 33.7 (SD 10.6), 33.5 (SD 10.6), and 34.0 (SD 10.5) years respectively; 54.4% of the patients were females, 54.8% were Muslims, 56.2% admitted they had pain, 60.8% and 46.5% had anxiety and depressive symptoms respectively, while 68.7% had poor sleep quality. The mean global score of sleep quality for patients was 9.2 (SD 3.6) while that of the control was 3.8 (SD 1.4). The difference was statistically significant (t = 20.834, P value < 0.001, 95% CI 4.891-5.910). Islamic religious faith, presence of pain, anxiety symptoms, and depressive symptoms were significantly associated with poor quality of sleep (P value < 0.05). Multiple regression analysis identified being a Muslim (OR 6.422, P value 0.027, 95% CI 0.196-0.907), pain (OR 8.038, P value < 0.001, 95% CI 0.016-0.091), and anxiety symptoms (OR 5.253, P value < 0.001, 95% CI 0.136-0.473) as predictors of poor sleep quality among the patients.

CONCLUSION

Poor quality of sleep is common in primary care patients. Efforts should be made to improve its recognition, identify associated factors, and consider a holistic approach to patients' care.

Tetrandrine, an antihypertensive alkaloid, improves the sleep state of spontaneously hypertensive rats (SHRs)

ETHNOPHARMACOLOGICAL RELEVANCE

Radix of Stephania tetrandrae S. Moore has been used since antiquity in China as an antirheumatic, antihypertension, analgesic and antipyretic agent. Tetrandrine is the major component of Stephania tetrandrae. This study aims to evaluate the antihypertensive and hypnotic effect of tetrandrine on spontaneously hypertensive rats (SHR) and the possible mechanisms.

MATERIALS AND METHODS

Electroencephalography (EEG) and electromyography (EMG) were recorded in freely moving rats and the sleep parameters were analyzed with SleepSign software. The levels of serotonin (5-HT), norepinephrine (NE), dopamine (DA) and their metabolites were examined to investigate the underlying mechanisms by using HPLC-ECD. Blood pressure was measured by noninvasive blood pressure tail cuff test.

RESULTS

Tetrandrine (100mg/kg, i.g.) significantly suppressed blood pressure of SHR rats day by day during three days treatment. Meanwhile, tetrandrine remarkably improved the sleep efficiency by increasing total sleep time, rapid eye movement (REM) sleep and non-REM (NREM) sleep (including deep sleep and light sleep) time from the first day. Three days treatment of tetrandrine induced 5-HT concentration decrease in DRN, 5-HIAA concentration increase in LC and 5-HIAA/5-HT ratio increase in VTA and LC. In contrast, no changes in NE and DA concentrations in the DRN, VTA and LC occurred in SHR after tetrandrine treatment. These results indicate that modulation of 5-HT, its metabolite 5-HIAA and the 5-HIAA/5-HT ratio in DRN, VTA and LC are likely the mechanism of antihypertensive and hypnotic effects of tetrandrine at least in part.

CONCLUSION

This is the first observation that tetrandrine possesses both anti-hypertension and hypnotic effects in SHR and suggested that tetrandrine may be useful for the treatment of hypertension patients who accompanied with short sleep time and poor sleep efficiency.

Sleep disturbance among spontaneously hypertensive rats is mediated by an α1-adrenergic mechanism

BACKGROUND

Inadequate sleep may aggravate hypertension, but the pathophysiology of sleep disturbance in hypertension remains unknown. Among spontaneously hypertensive rats (SHR), sleep disturbance co-occurred with sympathetic hyperactivity; therefore, we hypothesized that the sleep disturbance can be alleviated by antagonizing the adrenergic overdrive.

METHODS

Polysomnographic recording was performed in SHR by telemetry. The animals were first injected with saline, and 2 days later with a hypotensive agent. Cardiac and vascular sympathetic activity were assessed using the normalized low-frequency power (LF%) of heart rate variability and the low-frequency power of arterial pressure variability (BLF), respectively.

RESULTS

A comparison was made between the saline and hypotensive drug treatments. During quiet sleep (QS), the α1-blocker prazosin induced a significant decrease in BLF, but had no effect on LF%. The total time and bout duration of QS were lengthened and QS interruption was reduced (P < 0.05 for all). When both α1- and α2-adrenoceptors were blocked by phentolamine, both BLF and LF% were lower (P < 0.05 for both), but no modification to sleep structure could be observed. To antagonize β-adrenergic activity, atenolol and propranolol were injected. The LF% after either antagonist treatment was significantly decreased; however, sleep structure was not significantly changed. The QS-promoting effect of prazosin is specific to SHR, because prazosin is ineffective when administered to Wistar-Kyoto rats.

CONCLUSIONS

α1-adrenergic antagonism may reverse, at least partially, the poor sleep quality of SHR, suggesting a vicious cycle can be established between adrenergic overdrive and sleep disturbance.

Insomnia symptoms and HIV infection among participants in the Women's Interagency HIV Study

OBJECTIVES

This study assessed the prevalence of insomnia symptoms among women with and without HIV-infection and examined factors associated with insomnia.

DESIGN

Participants (n = 1682) were enrolled in the Women's Interagency HIV Study (WIHS); 69% were infected with HIV. This was a cross-sectional analysis of data from standardized interviewer-administered instruments and physical/gynecological exams. Analysis focused on sociodemographics, sleep measures, depressive symptoms, drug use, alcohol consumption, medications, and HIV-related clinical variables. Women were classified as having symptoms of insomnia if they reported either difficulty initiating sleep, difficulty maintaining sleep, or early morning awakening ≥ 3 times a week in the past 2 weeks.

RESULTS

Overall, HIV-infected women were 17% more likely to endorse insomnia symptoms than uninfected women (OR = 1.17, 95% CI: 1.04-1.34, P < 0.05). The adjusted prevalence of insomnia symptoms varied by HIV status and age groups. Among women ages 31-40 years, those with HIV infection were 26% more likely to endorse insomnia symptoms than their counterparts (OR = 1.26, 95% CI: 1.01-1.59, P < 0.05). No significant differences were observed in the likelihood of reporting insomnia symptoms based on HIV treatment type. Multivariate-adjusted regression analyses showed that depression was the most consistent and significant independent predictor of the likelihood of reporting insomnia symptoms across all age strata.

CONCLUSIONS

Insomnia symptoms are common among both HIV-infected and uninfected women. Prevalence of insomnia did not vary significantly by HIV status, except among younger women. Younger women with HIV infection are at greater risk for experiencing insomnia symptoms.