title: Sleep disturbances in children with human immunodeficiency virus infection.
abstract: OBJECTIVE
  To describe the sleep patterns and level of fatigue in children and adolescents (6-18 years of age) with HIV infection, compared with ethnic-, gender-, and age-matched healthy children in the home setting.
  
  
  METHODS
  Descriptive, comparative.
  
  
  METHODS
  Conducted in each child's home environment.
  
  
  METHODS
  Eighteen HIV-infected and 15 noninfected children completed the study. The Centers for Disease Control and Prevention HIV classifications for the 18 HIV-infected children were: A (n = 7), B (n = 6), and C (n = 5).
  
  
  METHODS
  A symptom diary was developed using a previously validated fatigue assessment scale, modified for use with children. Content validity of the diary was established with a panel of 5 experts in child development and pediatric HIV disease. Children were asked to complete the diary each morning and evening for 3 days. Each child wore a wrist actigraph during the same period.
  
  
  RESULTS
  The HIV-infected children had significantly more wake time after sleep onset, compared with noninfected children (13.55% vs 7. 47%). The HIV-infected children had more awakenings (25.33 vs 16.71) and were awake for longer periods (3.01 vs 1.01 minutes), compared with noninfected children. By parent report, 7 HIV-infected children napped and 2 noninfected children napped, indicating greater daytime fatigue in the HIV-infected children. HIV-infected children also reported a greater level of evening tiredness (2.47 vs 1.8).
  
  
  CONCLUSIONS
  The findings from this study suggest that sleep disturbances occur in HIV-infected children, similar to findings previously described in HIV-infected adults. Additional research is necessary to characterize the nature and patterns of sleep disturbance and fatigue related to pediatric HIV-infection, to assess the impact these may have on daily activities, and to develop strategies to improve sleep for these children.
authors.affiliation: School of Nursing, University of California San Francisco, San Francisco, California 94143, USA. lfranck@itsa.ucsf.edu
authors.forename: L S
authors.initials: LS
authors.lastname: Franck
authors.forename: L M
authors.initials: LM
authors.lastname: Johnson
authors.forename: K
authors.initials: K
authors.lastname: Lee
authors.forename: C
authors.initials: C
authors.lastname: Hepner
authors.forename: L
authors.initials: L
authors.lastname: Lambert
authors.forename: M
authors.initials: M
authors.lastname: Passeri
authors.forename: E
authors.initials: E
authors.lastname: Manio
authors.forename: A
authors.initials: A
authors.lastname: Dorenbaum
authors.forename: D
authors.initials: D
authors.lastname: Wara
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005221:Fatigue / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D012893:Sleep Wake Disorders / Q000209:etiology*