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Current HIV Research

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ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

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Research Article

Prevalence of Risk Factors Associated With Poor Quality of Sleep in People Living with HIV and the Correlation between Quality of Sleep and Cd4+ T Lymphocyte Reconstitution: A Cross-Sectional Study from Turkey

Author(s): Ozge Eren Korkmaz* and Figen Kaptan Aydoğmuş*

Volume 22, Issue 3, 2024

Published on: 13 May, 2024

Page: [202 - 211] Pages: 10

DOI: 10.2174/011570162X300844240507095129

Price: $65

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Abstract

Introduction: The prevalence of sleep disorders in people living with HIV (PLWH) is higher than in the general population. Even if viral suppression is achieved with Antiretroviral Therapy (ART), the chronic immune activation and increased inflammation due to immune reconstitution persist. The aim of our study was to determine the prevalence of poor quality of sleep (QoS) and associated risk factors in PLWH and to investigate the relationship between poor QoS and CD4 T lymphocyte count and CD4 reconstitution.

Methods: PLWH ≥18 years old, attending for routine HIV monitoring were recruited. PLWH with conditions that may affect their QoS (pregnant, hospitalized, malignancy, substance-alcohol abuse, psychiatric disease or treatment, sleeping pill) were excluded. Pittsburgh Sleep Quality Index (PSQI, score ≥5 indicates poor QoS), Epworth Sleepiness Scale (ESS, score ≥11 indicates daytime sleepiness), and Beck Depression Scale (BDS, score ≥10 indicates clinical depression) were applied. CD4+ T lymphocyte reconstitution (current-baseline CD4+ count) and CD4+ T lymphocyte reconstitution rate [(current-baseline CD4+ count)/duration of HIV infection in years] were calculated for PLWH on ART. Student t-test and Pearson’s chi-squared test were used for analysing the data, and p<0.05 was considered significant.

Results: A total of 131 (15 newly diagnosed, 116 on ART for at least six months) PLWH were enrolled. Poor QoS was detected in 60.3% of PLWH. When compared, the ratio was higher in newly diagnosed PLWH (vs PLWH on ART, p>0,05). Daytime sleepiness in PLWH with poor Qos (p=0.04) was significantly increased (vs good QoS). Clinical depression (p=0.001) was significantly more common in PLWH with poor QoS (vs good QoS). Although statistically nonsignificant (p>0,05), younger age, female sex, being single, homosexüel sexual preference, high income and living with the family were associated with poor QoS. No association was found between the ART regime and QoS. PLWH with poor QoS had a higher CD4+ T lymphocyte count (p>0,05), a higher number of CD4+ T lymphocyte reconstitution (p<0.05), and a higher reconstitution rate than PLWH with good QoS (p<0.05).

Conclusion: Prevalence of poor QoS was high in our cohort. Poor QoS was associated with CD4+ T lymphocyte reconstitution and reconstitution rate.

Keywords: HIV, Sleep quality, CD4 + T lymphocyte, sleep disorders in PLWH, chronic immune activation, inflammation, reconstitution rate.

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[1]
Robert C. Human immunodeficiency viruses. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. (9th ed..). Elsevier 2020; vol. 2020: pp. 2202-19.
[2]
Bedir YFG, Şişman FNAE. The relationship between sleep quality and emotion-behavior problems in adolescents. J Turk Sleep Med 2020; 7(1): 17-23.
[3]
Güneş A, Şensoy B. Sleepiness, insomnia, and sleep quality of hospitalized patients with coronavirus disease-2019: Sleep scale evaluation. J Turk Sleep Med 2022; 9(1): 11-5.
[http://dx.doi.org/10.4274/jtsm.galenos.2021.39974]
[4]
Aktaş H, Şaşmaz CT, Kılınçer A, et al. Investigation of factors related to physical activity level and sleep quality in adults. Mersin Univ Saglik Bilim Derg 2016; 8(2): 60-70.
[5]
Wu J, Wu H, Lu C, Guo L, Li P. Self-reported sleep disturbances in HIV-infected people: A meta-analysis of prevalence and moderators. Sleep Med 2015; 16(8): 901-7.
[http://dx.doi.org/10.1016/j.sleep.2015.03.027] [PMID: 26188954]
[6]
Allavena C, Guimard T, Billaud E, et al. Prevalence and risk factors of sleep disturbance in a large HIV-infected adult population. AIDS Behav 2016; 20(2): 339-44.
[http://dx.doi.org/10.1007/s10461-015-1160-5] [PMID: 26271816]
[7]
Redman KN, Karstaedt AS, Scheuermaier K. Increased CD4 counts, pain and depression are correlates of lower sleep quality in treated HIV positive patients with low baseline CD4 counts. Brain Behav Immun 2018; 69: 548-55.
[http://dx.doi.org/10.1016/j.bbi.2018.02.002] [PMID: 29452219]
[8]
Faraut B, Malmartel A, Ghosn J, et al. Sleep disturbance and total sleep time in persons living with HIV: A cross-sectional study. AIDS Behav 2018; 22(9): 2877-87.
[http://dx.doi.org/10.1007/s10461-018-2179-1] [PMID: 29855973]
[9]
Shi Y, Yang C, Xu L, et al. CD4+ T cell count, sleep, depression, and anxiety in people living with HIV: A growth curve mixture modeling. J Assoc Nurses AIDS Care 2020; 31(5): 535-43.
[http://dx.doi.org/10.1097/JNC.0000000000000112] [PMID: 31335460]
[10]
Daubert E, French AL, Burgess HJ, et al. 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(2): 222-30.
[http://dx.doi.org/10.1097/QAI.0000000000002847] [PMID: 34732681]
[11]
Cunha GH, Ramalho AKL, Fontenele MSM, Siqueira LR, Fechine FV, Medeiros MS. Prevalence of sleep disorders and associated factors in people living with HIV in the ceará, Brazil: A cross-sectional study. J Assoc Nurses AIDS Care 2022; 33(4): 436-47.
[http://dx.doi.org/10.1097/JNC.0000000000000326] [PMID: 35120074]
[12]
Gutierrez J, Tedaldi EM, Armon C, Patel V, Hart R, Buchacz K. Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea. SAGE Open Med 2019; 7
[http://dx.doi.org/10.1177/2050312119842268] [PMID: 31001423]
[13]
Fekete EM, Williams SL, Skinta MD. Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV. Psychol Health 2018; 33(3): 398-415.
[http://dx.doi.org/10.1080/08870446.2017.1357816] [PMID: 28749185]
[14]
Seay JS, McIntosh R, Fekete EM, et al. Self-reported sleep disturbance is associated with lower CD4 count and 24-hour urinary dopamine levels in ethnic minority women living with HIV. Psychoneuroendocrinology 2013; 38(11): 2647-53.
[http://dx.doi.org/10.1016/j.psyneuen.2013.06.022]
[15]
Effendy E, Amin MM, De Vega L, Utami N. The association between CD-4 level, stress and depression symptoms among people living with HIV/AIDS. Open Access Maced J Med Sci 2019; 7(20): 3459-63.
[http://dx.doi.org/10.3889/oamjms.2019.446] [PMID: 32002074]
[16]
Yan DQ, Huang YX, Chen X, Wang M, Li J, Luo D. Application of the Chinese version of the pittsburgh sleep quality index in people living with HIV: Preliminary reliability and validity. Front Psychiatry 2021; 12: 676022.
[http://dx.doi.org/10.3389/fpsyt.2021.676022] [PMID: 34295273]
[17]
Oshinaike O, Akinbami A, Ojelabi O, Dada A, Dosunmu A, Olabode JS. Quality of sleep in an HIV population on antiretroviral therapy at an urban tertiary centre in Lagos, Nigeria. Neurol Res Int 2014; 2014: 298703.
[http://dx.doi.org/10.1155/2014/298703] [PMID: 24876959]
[18]
Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28(2): 193-213.
[http://dx.doi.org/10.1016/0165-1781(89)90047-4] [PMID: 2748771]
[19]
Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 1991; 14(6): 540-5.
[http://dx.doi.org/10.1093/sleep/14.6.540] [PMID: 1798888]
[20]
Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev 1988; 8(1): 77-100.
[http://dx.doi.org/10.1016/0272-7358(88)90050-5]
[21]
Huang X, Li H, Meyers K, et al. Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China. Sci Rep 2017; 7(1): 3657.
[http://dx.doi.org/10.1038/s41598-017-03968-3] [PMID: 28623361]
[22]
Milinkovic A, Singh S, Simmons B, Pozniak A, Boffito M, Nwokolo N. Multimodality assessment of sleep outcomes in people living with HIV performed using validated sleep questionnaires. Int J STD AIDS 2020; 31(10): 996-1003.
[http://dx.doi.org/10.1177/0956462420941693] [PMID: 32772688]
[23]
Wallace DM, Alcaide ML, Wohlgemuth WK, et al. Prevalence and correlates of restless legs syndrome in men living with HIV. PLoS One 2021; 16(10): e0258139.
[http://dx.doi.org/10.1371/journal.pone.0258139] [PMID: 34597340]
[24]
Georg Behrens. Introduction to the EACS guidelines 2022. Available from: https://www.eacsociety.org/media/guidelines-11.1_final_09-10.pdf
[25]
Gray J, Young B. Acute onset insomnia associated with the initiation of raltegravir: A report of two cases and literature review. AIDS Patient Care STDS 2009; 23(9): 689-90.
[http://dx.doi.org/10.1089/apc.2009.0012] [PMID: 19663717]
[26]
Ren J, Zhao M, Liu B, et al. Factors associated with sleep quality in HIV. J Assoc Nurses AIDS Care 2018; 29(6): 924-31.
[http://dx.doi.org/10.1016/j.jana.2018.04.006] [PMID: 29801726]
[27]
Elliot ER, Wang X, Singh S, et al. Increased dolutegravir peak concentrations in people living with human immunodeficiency virus aged 60 and over, and analysis of sleep quality and cognition. Clin Infect Dis 2019; 68(1): 87-95.
[http://dx.doi.org/10.1093/cid/ciy426] [PMID: 29771285]
[28]
Nokes KM, Kendrew J. Correlates of sleep quality in persons with HIV disease. J Assoc Nurses AIDS Care 2001; 12(1): 17-22.
[http://dx.doi.org/10.1016/S1055-3290(06)60167-2] [PMID: 11211669]
[29]
Rubinstein ML, Selwyn PA. High prevalence of insomnia in an outpatient population with HIV infection. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 19(3): 260-5.
[http://dx.doi.org/10.1097/00042560-199811010-00008] [PMID: 9803968]
[30]
Crum-Cianflone NF, Roediger MP, Moore DJ, et al. Prevalence and factors associated with sleep disturbances among early-treated HIV-infected persons. Clin Infect Dis 2012; 54(10): 1485-94.
[http://dx.doi.org/10.1093/cid/cis192] [PMID: 22431801]
[31]
Wibbeler T, Reichelt D, Husstedt IW, Evers S. Sleepiness and sleep quality in patients with HIV infection. J Psychosom Res 2012; 72(6): 439-42.
[http://dx.doi.org/10.1016/j.jpsychores.2012.03.003] [PMID: 22656440]
[32]
Mazzitelli M, Trunfio M, Milinkovic A, et al. Sleep disturbances and their correlation with cardiovascular risk, obesity, and mood disorders in people with HIV. AIDS 2023; 37(6): 925-34.
[http://dx.doi.org/10.1097/QAD.0000000000003493] [PMID: 36723511]
[33]
Jain D, Kumar J, Katyal VK, Jain P, Malik D. Evaluation of depression, anxiety and insomnia in people living with HIV/AIDS in India. HIV AIDS Rev 2023; 22(2): 138-49.
[http://dx.doi.org/10.5114/hivar.2023.126586]
[34]
Uthman OA, Magidson JF, Safren SA, Nachega JB. Depression and adherence to antiretroviral therapy in low-, middle- and high-income countries: A systematic review and meta-analysis. Curr HIV/AIDS Rep 2014; 11(3): 291-307.
[http://dx.doi.org/10.1007/s11904-014-0220-1] [PMID: 25038748]
[35]
Rick F, Odoke W, van den Hombergh J, Benzaken AS, Silva AVI. Impact of coronavirus disease (COVID-19) on HIV testing and care provision across four continents. HIV Med 2022; 23(2): 169-77.
[http://dx.doi.org/10.1111/hiv.13180] [PMID: 34632685]
[36]
Vicente BM, Neto JV, Quaresma MVLS, et al. Covid-19 social distancing, lifestyle and health outcomes among persons living with HIV (PLWH): A web-based survey. AIDS Behav 2022; 26(12): 4144-55.
[http://dx.doi.org/10.1007/s10461-022-03740-3] [PMID: 35699860]
[37]
Zabel M, Wilson TW, Sayles H, May PE, Furl R, Bares SH. The impact of the COVID-19 pandemic on mental health and substance use among people with and without HIV. Pathogens 2023; 12(3): 461.
[http://dx.doi.org/10.3390/pathogens12030461] [PMID: 36986383]
[38]
Kabeloğlu V, Gül G. Investigation of sleep quality and associated social psychological factors during the COVID-19 outbreak. J Turk Sleep Med 2021; 8(2): 97-104.
[http://dx.doi.org/10.4274/jtsm.galenos.2021.53244]
[39]
Gay CL, Zak RS, Lerdal A, Pullinger CR, Aouizerat BE, Lee KA. Cytokine polymorphisms and plasma levels are associated with sleep onset insomnia in adults living with HIV/AIDS. Brain Behav Immun 2015; 47: 58-65.
[http://dx.doi.org/10.1016/j.bbi.2014.11.018] [PMID: 25535857]
[40]
GebreEyesus FA, Degu FS, Yohanes YB, Azagew AW. Sleep quality and associated factors among adult people living with hiv on follow-up at dessie town governmental health facilities antiretroviral therapy clinics, Northeast, Ethiopia, 2020, a multicenter cross-sectional study. BMC Psychiatry 2023; 23(1): 132.
[http://dx.doi.org/10.1186/s12888-023-04619-w]
[41]
Mengistu N, Azale T, Yimer S, Fikreyesus M, Melaku E, Shumye S. Quality of sleep and associated factors among people living with HIV/AIDS on follow up at Ethiopian Zewditu memorial hospital, 2018. Sleep Sci Pract 2021; 5(1): 2.
[http://dx.doi.org/10.1186/s41606-020-00056-w]
[42]
Bruno G, Giotta M, Perelli S, et al. Prevalence and risk factors for poor sleep quality in people living with hIV: Preliminary observations from an HIV outpatient clinic. Viruses 2023; 15(8): 1715.
[http://dx.doi.org/10.3390/v15081715] [PMID: 37632057]
[43]
Tadesse A, Badasso K, Edmealem A. Poor sleep quality and associated factors among people living with HIV/AIDS attending ART clinic at Tirunesh Beijing Hospital, Addis Ababa, Ethiopia. Aids Res Treat 2023; 2023: 6381885.
[http://dx.doi.org/10.1155/2023/6381885] [PMID: 37359994]
[44]
Wirth MD, Jaggers JR, Dudgeon WD, et al. Association of markers of inflammation with sleep and physical activity among people living with HIV or AIDS. AIDS Behav 2015; 19(6): 1098-107.
[http://dx.doi.org/10.1007/s10461-014-0949-y] [PMID: 25399034]

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