Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea.

Authors:
Jeydith Gutierrez
Jeydith Gutierrez
University of Iowa Hospitals and Clinics and The Roy J. and Lucille A. Carver College of Medicine
Ellen M Tedaldi
Ellen M Tedaldi
Temple University School of Medicine
United States
Carl Armon
Carl Armon
Cerner Corporation
Kansas City | United States
Vaidahi Patel
Vaidahi Patel
Lewis Katz School of Medicine
Rachel Hart
Rachel Hart
The University of Dundee
Kate Buchacz
Kate Buchacz
Johns Hopkins University
United States

SAGE Open Med 2019 8;7:2050312119842268. Epub 2019 Apr 8.

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Objective: To evaluate sleep disturbances in a diverse, contemporary HIV-positive patient cohort and to identify demographic, clinical, and immune correlates.

Methods: A convenience sample of 176 patients from a racially and ethnically diverse HIV-positive patient cohort in an urban population. This was a cross-sectional, epidemiologic study. We surveyed participants using multiple standardized instruments to assess depression, sleep quality, and risk for sleep apnea. We analyzed demographic, behavioral, and clinical correlates.

Results: A total of 56% of participants were female, 75% Black and 64% had heterosexual HIV risk. The median age was 49 years. Poor sleep quality (Pittsburgh Sleep Quality Index > 5) was reported by 73% of patients and 52% met insomnia diagnosis criteria. A single question about self-reported sleep problems predicted a Pittsburgh Sleep Quality Index > 5 with a sensitivity and specificity of 82% and 81%, respectively. Female sex was significantly associated with higher risk of poor sleep quality, depression, and insomnia, whereas higher risk of obstructive sleep apnea was significantly associated with older age, male sex, obesity (body mass index ⩾ 30 kg/m), and metabolic comorbidities. High risk for obstructive sleep apnea, high rate of depression, and poor sleep hygiene represent treatment targets for sleep problems in HIV patients.

Conclusion: Sleep disturbances were common in this patient cohort, although largely undiagnosed and untreated. Sleep problems are linked to worse disease progression and increased cardiovascular mortality. Screening for sleep problems with a single question had high sensitivity and specificity. In those patients with self-reported sleep problems, screening for obstructive sleep apnea, depression, and sleep hygiene habits should be part of routine HIV care.

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http://dx.doi.org/10.1177/2050312119842268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454647PMC
April 2019
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