Factors associated with poor sleep quality among HIV-positive individuals in Mexico City

E Rodríguez-Estrada, MC Iglesias-Chiesa, A Fresán-Orellana, G Reyes-Terán

DOI: https://doi.org/10.17711/SM.0185-3325.2018.016

Abstract


Introduction. Sleep quality is commonly impaired in medical disorders, and the HIV-positive population is particularly vulnerable to complaint from sleep disturbances.

Objective. To determine the prevalence of poor sleep quality and the factors associated with it, in a population of HIV positive Mexican out patients.

Method. A cross sectional study was done. A sample of 367 HIV-positive subjects over 18 years completed a set of self-administered questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Athens Insomnia Scale, and the Beck Depression Inventory. Sociodemographic and clinical data were recorded.

Results. Of the respondents, 82.8% (n = 304) were male. The mean age of the patients was 36.6 (SD = 9.4) years, and the mean educational level was 12.2 (SD = 3.8) years. According to the PSQI, 58.6% (n = 215) had poor sleep quality. Poor sleep quality was more common in those who had lived longer with HIV, had started their antiretroviral treatment later, had suboptimal antiretroviral adherence, had a CD4 cell count < 200 cells/µL, reported illicit drug use, had concomitant medications, or had insomnia, sleepiness, or depressive symptoms. In multivariate analyses, poor sleep quality was associated with depressive symptoms, illicit drug use, a CD4 count < 200 cells/µL, and time elapsed since HIV diagnosis.

Discussion and conclusion. Poor sleep quality is common in HIV patients. Early identification of patients with poor sleep quality through vigilance for factors associated with it might facilitate prompt treatment.


Keywords


HIV infection; depression; sleep quality

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References


Sleep in America Poll. (2015). Sleep Health, 1(2), e14-e375. doi: http://dx.doi.org/10.1016/j.sleh.2015.02.005

Allavena, C., Guimard, T., Billaud, E., De la Tullaye, S., Reliquet, V., Pineau, S., . . . Group, C. O.-P. d. l. L. T. d. S. S. (2016). Prevalence and Risk Factors of Sleep Disturbance in a Large HIV-Infected Adult Population. AIDS Behav, 20(2), 339-344. doi: 10.1007/s10461-015-1160-5

Berry, R. B., & Harding, S. M. (2004). Sleep and medical disorders. Med Clin North Am, 88(3), 679-703, ix. doi: 10.1016/j.mcna.2004.01.006

Bouscoulet, L. T., Vázquez-García, J. C., Muiño, A., Márquez, M., López, M. V., Oca, M. M. d., . . . Pérez-Padilla, R. (2008). Prevalence of Sleep Related Symptoms in Four Latin American Cities. J Clin Sleep Med, 4(6), 579-585.

Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 28(2), 193-213.

Chauhan, A., Turchan, J., Pocernich, C., Bruce-Keller, A., Roth, S., Butterfield, D. A., . . . Nath, A. (2003). Intracellular human immunodeficiency virus Tat expression in astrocytes promotes astrocyte survival but induces potent neurotoxicity at distant sites via axonal transport. J Biol Chem, 278(15), 13512-13519. doi: 10.1074/jbc.M209381200

Dabaghzadeh, F., Khalili, H., Ghaeli, P., & Alimadadi, A. (2013). Sleep Quality and Its Correlates in HIV Positive Patients Who Are Candidates for Initiation of Antiretroviral Therapy. Iran J Psychiatry, 8(4), 160-164.

Garbarino, S., Lanteri, P., Durando, P., Magnavita, N., & Sannita, W. G. (2016). Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review. Int J Environ Res Public Health, 13(8). doi: 10.3390/ijerph13080831

Hastie, T., Tibshirani, R., & Friedman, J. (2009). The Elements of Statistical Learning Data Mining, Inference, and Prediction (Second edition ed.): Springer.

Hayashino, Y., Yamazaki, S., Takegami, M., Nakayama, T., Sokejima, S., & Fukuhara, S. (2010). Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: Results from a population-based survey. Sleep Medicine, 11, 366-371.

Huang, X., Li, H., Meyers, K., Xia, W., Meng, Z., Li, C., . . . Wu, H. (2017). Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China. Sci Rep, 7(1), 3657. doi: 10.1038/s41598-017-03968-3

Irwin, M. R., Olmstead, R., & Carroll, J. E. (2016). Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry, 80(1), 40-52. doi: 10.1016/j.biopsych.2015.05.014

Jimenez-Genchi, A., Monteverde-Maldonado, E., Nenclares-Portocarrero, A., Esquivel-Adame, G., & de la Vega-Pacheco, A. (2008). [Reliability and factorial analysis of the Spanish version of the Pittsburg Sleep Quality Index among psychiatric patients]. Gac Med Mex, 144(6), 491-496.

Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540-545.

Jordan, M. L., Perez-Escamilla, R., Desai, M. M., & Shamah-Levy, T. (2016). Household Food Insecurity and Sleep Patterns Among Mexican Adults: Results from ENSANUT-2012. J Immigr Minor Health, 18(5), 1093-1103. doi: 10.1007/s10903-015-0246-5

Jurado, S., Villegas, M. E., Mendez, L., Rodriguez, F., Loperena, V., & Varela, R. (1998). La estandarización del inventario de Depresión de Beck para residentes de la Ciudad de México. Salud Mental, 21(3), 26-31.

Koren, D., Dumin, M., & Gozal, D. (2016). Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes, 9, 281-310. doi: 10.2147/DMSO.S95120

Krystal, A. D., & Edinger, J. D. (2008). Measuring sleep quality. Sleep Med, 9 Suppl 1, S10-17. doi: 10.1016/s1389-9457(08)70011-x

Lorton, D., Lubahn, C. L., Estus, C., Millar, B. A., Carter, J. L., Wood, C. A., & Bellinger, D. L. (2006). Bidirectional communication between the brain and the immune system: implications for physiological sleep and disorders with disrupted sleep. Neuroimmunomodulation, 13(5-6), 357-374. doi: 10.1159/000104864

Mahoney, J. J., 3rd, De La Garza, R., 2nd, Jackson, B. J., Verrico, C. D., Ho, A., Iqbal, T., & Newton, T. F. (2014). The relationship between sleep and drug use characteristics in participants with cocaine or methamphetamine use disorders. Psychiatry Res, 219(2), 367-371. doi: 10.1016/j.psychres.2014.05.026

Norman, S. E., Chediak, A. D., Freeman, C., Kiel, M., Mendez, A., Duncan, R., . . . Nolan, B. (1992). Sleep disturbances in men with asymptomatic human immunodeficiency (HIV) infection. Sleep, 15(2), 150-155.

Oshinaike, O., Akinbami, A., Ojelabi, O., Dada, A., Dosunmu, A., & John Olabode, S. (2014). Quality of Sleep in an HIV Population on Antiretroviral Therapy at an Urban Tertiary Centre in Lagos, Nigeria. Neurol Res Int, 2014, 298703. doi: 10.1155/2014/298703

Portacarrero, A. N., & Genchi, A. J. (2005). Estudio de validación de la traducción al español de la Escala Atenas de Insomnio. Salud Mental, 28(5), 34-39.

Rodriguez, V., Magis, C., Casillas, J., Ramirez, H. V., Hernandez, G., Rentería, C. R., & Gonzalez, A. (2012). Internal consistency and factorial structure of the Beck Depression Inventory (BDI) in Mexican HIV-positive patients. Poster at XIX International AIDS Conference July 22-27 2012 Washington DC USA.

Saberi, P., Neilands, T. B., & Johnson, M. O. (2011). Quality of sleep: associations with antiretroviral nonadherence. AIDS Patient Care STDS, 25(9), 517-524. doi: 10.1089/apc.2010.0375

Sandoval-Rincon, M., Alcala-Lozano, R., Herrera-Jimenez, I., & Jimenez-Genchi, A. (2013). [Validation of the Epworth sleepiness scale in Mexican population]. Gac Med Mex, 149(4), 409-416.

Soldatos, C. R., Dikeos, D. G., & Paparrigopoulos, T. J. (2000). Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res, 48(6), 555-560.

Soldatos, C. R., Dikeos, D. G., & Paparrigopoulos, T. J. (2003). The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res, 55(3), 263-267.

Strazza, M., Pirrone, V., Wigdahl, B., & Nonnemacher, M. R. (2011). Breaking down the barrier: the effects of HIV-1 on the blood-brain barrier. Brain Res, 1399, 96-115. doi: 10.1016/j.brainres.2011.05.015

Tedaldi, E. M., Minniti, N. L., & Fischer, T. (2015). HIV-associated neurocognitive disorders: the relationship of HIV infection with physical and social comorbidities. Biomed Res Int, 2015, 641913. doi: 10.1155/2015/641913

Tello-Velasquez, J. R., Diaz-Llanes, B. E., Mezones-Holguin, E., Rodriguez-Morales, A. J., Huamani, C., Hernandez, A. V., & Arevalo-Abanto, J. (2015). [Poor quality of sleep associated with low adherence to highly active antiretroviral therapy in Peruvian patients with HIV/AIDS]. Cad Saude Publica, 31(5), 989-1002. doi: 10.1590/0102-311x00010014

Vosvick, M., Gore-Felton, C., Ashton, E., Koopman, C., Fluery, T., Israelski, D., & Spiegel, D. (2004). Sleep disturbances among HIV-positive adults: the role of pain, stress, and social support. J Psychosom Res, 57(5), 459-463. doi: 10.1016/j.jpsychores.2004.03.003

Wibbeler, T., Reichelt, D., Husstedt, I. W., & Evers, S. (2012). Sleepiness and sleep quality in patients with HIV infection. J Psychosom Res, 72(6), 439-442. doi: 10.1016/j.jpsychores.2012.03.003

Wu, J., Wu, H., Lu, C., Guo, L., & Li, P. (2015). Self-reported sleep disturbances in HIV-infected people: a meta-analysis of prevalence and moderators. Sleep Med, 16(8), 901-907. doi: 10.1016/j.sleep.2015.03.027