Sleep disorders in human immunodeficiency virus: a substudy of the pharmacokinetics and clinical observations in people over fifty (POPPY) study
Author(s)
Type
Journal Article
Abstract
Background
Self-reported sleep quality is poor in persons with human immunodeficiency virus (PWH), but prior studies commonly used nonspecific questionnaires, investigated only single sleep disorders, or lacked human immunodeficiency virus (HIV)-negative controls. We addressed these limitations in the Pharmacokinetics and Clinical Observations in People Over Fifty (POPPY) Sleep Substudy by assessing PWH and HIV-negative controls for insomnia, restless legs syndrome (RLS), and sleep apnea (SA).
Methods
Previously enrolled POPPY participants coenrolled in this substudy without regard to sleep symptoms. Participants completed validated sleep assessments including the Insomnia Severity Index questionnaire, International Restless Legs Syndrome Study Group questionnaire, and in-home, wrist-worn overnight oximetry. They also completed health-related quality of life questionnaires including 36-item Short Form (SF-36) and Patient-Reported Outcomes Measurement Information System (PROMIS) sleep questionnaires.
Results
We enrolled 357 PWH (246 >50 years of age; 111 between 18 and 50 years) and 126 HIV-negative controls >50 years of age. Among PWH, criteria were met by 21% for insomnia, 13% for RLS, and 6% for SA. Compared with HIV-negative controls, PWH had a higher risk of insomnia (adjusted odds ratio, 5.3; 95% confidence interval, 2.2–12.9) but not RLS or SA. Compared with PWH without insomnia, those with insomnia reported significantly worse scores on all SF-36 and PROMIS components; fewer than 30% reported previous diagnosis or treatment for insomnia.
Conclusions
Insomnia was more common in PWH, associated with worse health-related quality of life, and frequently undiagnosed. Further research should focus on the pathogenesis of insomnia in PWH and the development of effective screening and intervention strategies for this unique population.
Self-reported sleep quality is poor in persons with human immunodeficiency virus (PWH), but prior studies commonly used nonspecific questionnaires, investigated only single sleep disorders, or lacked human immunodeficiency virus (HIV)-negative controls. We addressed these limitations in the Pharmacokinetics and Clinical Observations in People Over Fifty (POPPY) Sleep Substudy by assessing PWH and HIV-negative controls for insomnia, restless legs syndrome (RLS), and sleep apnea (SA).
Methods
Previously enrolled POPPY participants coenrolled in this substudy without regard to sleep symptoms. Participants completed validated sleep assessments including the Insomnia Severity Index questionnaire, International Restless Legs Syndrome Study Group questionnaire, and in-home, wrist-worn overnight oximetry. They also completed health-related quality of life questionnaires including 36-item Short Form (SF-36) and Patient-Reported Outcomes Measurement Information System (PROMIS) sleep questionnaires.
Results
We enrolled 357 PWH (246 >50 years of age; 111 between 18 and 50 years) and 126 HIV-negative controls >50 years of age. Among PWH, criteria were met by 21% for insomnia, 13% for RLS, and 6% for SA. Compared with HIV-negative controls, PWH had a higher risk of insomnia (adjusted odds ratio, 5.3; 95% confidence interval, 2.2–12.9) but not RLS or SA. Compared with PWH without insomnia, those with insomnia reported significantly worse scores on all SF-36 and PROMIS components; fewer than 30% reported previous diagnosis or treatment for insomnia.
Conclusions
Insomnia was more common in PWH, associated with worse health-related quality of life, and frequently undiagnosed. Further research should focus on the pathogenesis of insomnia in PWH and the development of effective screening and intervention strategies for this unique population.
Date Issued
2021-01
Date Acceptance
2020-11-11
Citation
Open Forum Infectious Diseases, 2021, 8 (1), pp.1-9
ISSN
2328-8957
Publisher
Oxford University Press
Start Page
1
End Page
9
Journal / Book Title
Open Forum Infectious Diseases
Volume
8
Issue
1
Copyright Statement
Open Forum Infectious Diseases®2020
Published by Oxford University Press on behalf of Infectious Diseases Society of America 2020.
This work is written by (a) US Government employee(s) and is in the public domain in the US. This
Open Access article contains public sector information licensed under the Open Government
Licence v2.0 (http://www.nationalarchives.gov.uk/doc/open-government-licence/version/2/).
DOI: 10.1093/ofid/ofaa561
Published by Oxford University Press on behalf of Infectious Diseases Society of America 2020.
This work is written by (a) US Government employee(s) and is in the public domain in the US. This
Open Access article contains public sector information licensed under the Open Government
Licence v2.0 (http://www.nationalarchives.gov.uk/doc/open-government-licence/version/2/).
DOI: 10.1093/ofid/ofaa561
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000610004000015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
APNEA-HYPOPNEA
EVENTS
HIV
Immunology
INDEX
Infectious Diseases
insomnia
INSOMNIA SYMPTOMS
Life Sciences & Biomedicine
Microbiology
OUTCOMES
OXIMETRY
patient reported outcomes measures
PREVALENCE
QUALITY
restless legs syndrome
RESTLESS LEGS SYNDROME
Science & Technology
sleep apnea syndromes
Publication Status
Published
Article Number
ofaa561
Date Publish Online
2020-11-18