title: Evaluating sleep and cognition in HIV.
abstract: OBJECTIVE
  To examine the relationship between measures of sleep quality and cognitive performance in HIV-positive individuals stable on combination antiretroviral therapy.
  
  
  METHODS
  Multimethod assessments of sleep quality, patterns, and cognitive performance were assessed in a predominantly black HIV-positive cohort.
  
  
  METHODS
  Sleep quality and patterns were characterized in 36 subjects by polysomnogram, 2-week actigraphy monitoring, and validated sleep questionnaires. Cognitive performance was assessed with a battery of neuropsychological tests.
  
  
  RESULTS
  The majority of participants were cognitively impaired [based on Frascati (75%) criteria]. Self-reported mean scores on the Pittsburgh sleep quality index and the insomnia severity scale suggested poor sleep quality. Better cognitive performance, particularly on tasks of attention, frontal/executive function, and psychomotor/motor speed, was associated with polysomnogram sleep indices (ie, reduced wake after sleep onset, greater sleep efficiency, greater sleep latency, and greater total sleep time). Thirty-seven percent of participants had sleep patterns suggestive of chronic partial sleep deprivation, which was associated with significantly worse performance on the digit symbol test (P = 0.006), nondominant pegboard (P = 0.043), and verbal fluency tests (P = 0.044).
  
  
  CONCLUSIONS
  Our results suggest that compromised sleep quality and duration may have a significant impact on cognitive performance in HIV-positive individuals. Future studies are warranted to determine the utility of sleep quality and quantity indices as potential predictive biomarkers for development and progression of future HIV-associated neurocognitive disorder.
authors.affiliation: *Department of Neurology, Johns Hopkins University, Baltimore, MD; †Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD; ‡Departments of Pathology, Epidemiology, and Medicine, Johns Hopkins University, Baltimore, MD; and §Department of Psychiatry and Behavioral Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Charlene E
authors.initials: CE
authors.lastname: Gamaldo
authors.forename: Alyssa
authors.initials: A
authors.lastname: Gamaldo
authors.forename: Jason
authors.initials: J
authors.lastname: Creighton
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Salas
authors.forename: Ola A
authors.initials: OA
authors.lastname: Selnes
authors.forename: Paula M
authors.initials: PM
authors.lastname: David
authors.forename: Gilbert
authors.initials: G
authors.lastname: Mbeo
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Parker
authors.forename: Amanda
authors.initials: A
authors.lastname: Brown
authors.forename: Justin C
authors.initials: JC
authors.lastname: McArthur
authors.forename: Michael T
authors.initials: MT
authors.lastname: Smith
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D044966:Anti-Retroviral Agents