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Sleep, Function and HIV: A Multi-Method Assessment

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Abstract

Amongst HIV+ individuals, sleep complaints have been recognized as common and debilitating; but have rarely been formally assessed or compared to controls using validated sleep tools. In this study we conducted structured interview for sleep disorders, polysomnography, 2-week home (ambulatory) monitoring and validated sleep/functional questionnaires. 56 % (14/25) of HIV+ participants and 0 % (0/19) of controls fulfilled the diagnostic criteria for insomnia. Insomnia severity scores were correlated with fatigue and anxiety symptoms. Sleep latency on 2-week actigraphy was significantly longer (P = 0.027) for HIV+ participants and associated with lower MOS-HIV scores. Sleep quality was significantly reduced in HIV+ participants based on validated questionnaires of overall sleep quality (P = 0.0017) and insomnia related symptoms (P < 0.001) even after adjusting for education and affective symptoms. HIV+ individuals are suffering with under-diagnosed sleep disorders that are negatively impacting quality of life and functional capabilities. Further studies aimed at improving recognition of sleep disorders and implementation of efficacious medical and behavioral treatment could improve functioning and disease management.

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Acknowledgments

This publication was made possible by Grant Number UL1 RR 025005 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/. This study was also supported by award 5P30MH075673-S02 from the National Institute of Mental Health (NIMH) (PI JCM), a Developmental Grant from JHU NIMH Center for Novel Therapeutics of HIV-associated Cognitive Disorders (to author CG), and a Developmental Grant from JHU Center for Mind–Body Research (CMBR) (PI Jennifer Haythornthwaite PI to author CG). The recruitment of participants was assisted by an existing cohort, funded by NIMH, the Central Nervous System HIV Antiretroviral Therapy Effects Research (CHARTER)]. The authors thank Ms. Bernadette Clark and Ms. Rebecca Clark for their editing assistance with this manuscript.

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Authors and Affiliations

  1. Department of Neurology, The Johns Hopkins Outpatient Center, Johns Hopkins University, 600 N. Wolfe St., Meyer 6-119, Baltimore, MD, 21287, USA

    Charlene E. Gamaldo, Rachel E. Salas, Paula M. David & Gilbert Mbeo

  2. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Adam P. Spira & Rebecca S. Hock

  3. Departments of Neurology, Pathology, Epidemiology, and Medicine, Johns Hopkins University, Baltimore, MD, USA

    Justin C. McArthur

  4. Department of Psychiatry and Behavioral Medicine, Johns Hopkins University, Baltimore, MD, USA

    Michael T. Smith

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  1. Charlene E. Gamaldo
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  2. Adam P. Spira
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  3. Rebecca S. Hock
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  4. Rachel E. Salas
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  5. Justin C. McArthur
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  8. Michael T. Smith
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Correspondence to Charlene E. Gamaldo.

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Gamaldo, C.E., Spira, A.P., Hock, R.S. et al. Sleep, Function and HIV: A Multi-Method Assessment. AIDS Behav 17, 2808–2815 (2013). https://doi.org/10.1007/s10461-012-0401-0

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