title: Types of sleep problems in adults living with HIV/AIDS.
abstract: OBJECTIVE
  To characterize specific types of sleep problems experienced by adults with HIV.
  
  
  METHODS
  The design was cross-sectional involving sleep questionnaires, diaries, and wrist actigraphy. The convenience sample included 290 adults living with HIV, 22-77 years of age. Measures included self-report for sleep onset latency, and wrist actigraphy estimates of total sleep time at night, wake after sleep onset, and daytime sleep.
  
  
  RESULTS
  Nearly half (45%) of the sample slept < 6 h per night. Difficulty falling asleep was reported by 34%, and 56% had fragmented sleep according to actigraphy; 20% had both problems, and 30% were good sleepers. Participants reporting difficulty falling asleep had actigraphy and clinical measures similar to the good sleepers, but subjectively they experienced greater sleep disturbance and symptom burden (particularly anxiety and morning fatigue) and reported more use of sleep medication. Participants with fragmented sleep reported low levels of sleep disturbance and symptom burden similar to the good sleepers, despite actigraphy measures indicating they obtained less sleep both at night and during the day. Sleep fragmentation was also associated with sociodemographic factors and slightly lower CD4+ T-cell counts. Participants reporting both sleep problems had actigraphy and clinical profiles similar to those who had only fragmented sleep, but their symptom experience was similar to participants with only sleep initiation difficulties.
  
  
  CONCLUSIONS
  Findings support the need for targeting efforts to improve sleep for the majority of adults living with HIV/AIDS and tailoring interventions to the specific type of sleep problem regardless of the person's clinical and demographic profile.
authors.affiliation: Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, USA. Kathryn.lee@nursing.ucsf.edu
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
authors.forename: Caryl
authors.initials: C
authors.lastname: Gay
authors.forename: Carmen J
authors.initials: CJ
authors.lastname: Portillo
authors.forename: Traci
authors.initials: T
authors.lastname: Coggins
authors.forename: Harvey
authors.initials: H
authors.lastname: Davis
authors.forename: Clive R
authors.initials: CR
authors.lastname: Pullinger
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
mesh_terms: D056044:Actigraphy; D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis; D011795:Surveys and Questionnaires