title: Sleep, function and HIV: a multi-method assessment.
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.
authors.affiliation: Department of Neurology, The Johns Hopkins Outpatient Center, Johns Hopkins University, 600 N. Wolfe St., Meyer 6-119, Baltimore, MD, 21287, USA, cgamald1@jhmi.edu.
authors.forename: Charlene E
authors.initials: CE
authors.lastname: Gamaldo
authors.forename: Adam P
authors.initials: AP
authors.lastname: Spira
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Hock
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Salas
authors.forename: Justin C
authors.initials: JC
authors.lastname: McArthur
authors.forename: Paula M
authors.initials: PM
authors.lastname: David
authors.forename: Gilbert
authors.initials: G
authors.lastname: Mbeo
authors.forename: Michael T
authors.initials: MT
authors.lastname: Smith
mesh_terms: D056044:Actigraphy; D000203:Activities of Daily Living / Q000523:psychology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D004359:Drug Therapy, Combination; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D017286:Polysomnography; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents