title: Self-reported sleep disturbance is associated with lower CD4 count and 24-h urinary dopamine levels in ethnic minority women living with HIV.
abstract: BACKGROUND
  Sleep disturbance is associated with dopamine dysregulation, which can negatively impact immune status. Individuals living with HIV experience more sleep difficulties, and poor sleep may compound immune decrements associated with HIV infection. Little research has examined associations between sleep, dopamine, and immune status (CD4 count) in individuals with HIV. As ethnic minority women living with HIV (WLWH) are at heightened risk for HIV disease progression, we related sleep reports to both CD4 count and dopamine levels in a cohort of ethnic minority WLWH.
  
  
  METHODS
  Participants were 139 low-income WLWH (ages 20-62; 78.3% African-American or Caribbean) who reported both overall sleep quality and sleep disturbance on the Pittsburgh sleep quality index (PSQI). CD4 count and HIV viral load were measured via morning peripheral venous blood samples, and concentrations of dopamine were measured via 24-h urine collection. Covariates included HIV viral load, length of time since HIV diagnosis, HAART adherence, perceived stress and depression.
  
  
  RESULTS
  After controlling for all covariates, greater sleep disturbance was associated with significantly lower CD4 count (β=-.20, p=.03) and lower levels of dopamine (β=-.25, p=.04). Poorer overall sleep quality was marginally associated with lower CD4 count (β=-.16, p=.08), and was not associated with dopamine.
  
  
  CONCLUSIONS
  Our analyses suggest that sleep disturbance is independently related with immune status and dopamine levels in WLWH. Lower levels of dopamine may indicate neuroendocrine dysregulation and may impact immune and health status. Results highlight sleep disturbance rather than overall sleep quality as potentially salient to neuroendocrine and immune status in ethnic minority WLWH.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL, USA. Electronic address: jseay@psy.miami.edu.
authors.forename: Julia S
authors.initials: JS
authors.lastname: Seay
authors.forename: Roger
authors.initials: R
authors.lastname: McIntosh
authors.forename: Erin M
authors.initials: EM
authors.lastname: Fekete
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Fletcher
authors.forename: Mahendra
authors.initials: M
authors.lastname: Kumar
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D018791:CD4 Lymphocyte Count; D017691:Caribbean Region; D004298:Dopamine / Q000652:urine*; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000652:urine; D006801:Humans; D008875:Middle Aged; D011203:Poverty; D057566:Self Report; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000652:urine*; D019562:Viral Load
chemical_list: D004298:Dopamine
keywords: CD4 count; Dopamine; HIV; Sleep