Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea

Jeydith Gutierrez; Ellen M Tedaldi; Carl Armon; Vaidahi Patel; Rachel Hart; Kate Buchacz

doi:10.1177/2050312119842268

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Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea

Journal article

Open access

Peer reviewed

Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea

Jeydith Gutierrez, Ellen M Tedaldi, Carl Armon, Vaidahi Patel, Rachel Hart and Kate Buchacz

SAGE open medicine, Vol.7, pp.2050312119842268-2050312119842268

2019

DOI: 10.1177/2050312119842268

PMCID: PMC6454647

PMID: 31001423

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Abstract

To evaluate sleep disturbances in a diverse, contemporary HIV-positive patient cohort and to identify demographic, clinical, and immune correlates. A convenience sample of 176 patients from a racially and ethnically diverse HIV-positive patient cohort in an urban population. This was a cross-sectional, epidemiologic study. We surveyed participants using multiple standardized instruments to assess depression, sleep quality, and risk for sleep apnea. We analyzed demographic, behavioral, and clinical correlates. A total of 56% of participants were female, 75% Black and 64% had heterosexual HIV risk. The median age was 49 years. Poor sleep quality (Pittsburgh Sleep Quality Index > 5) was reported by 73% of patients and 52% met insomnia diagnosis criteria. A single question about self-reported sleep problems predicted a Pittsburgh Sleep Quality Index > 5 with a sensitivity and specificity of 82% and 81%, respectively. Female sex was significantly associated with higher risk of poor sleep quality, depression, and insomnia, whereas higher risk of obstructive sleep apnea was significantly associated with older age, male sex, obesity (body mass index ⩾ 30 kg/m ), and metabolic comorbidities. High risk for obstructive sleep apnea, high rate of depression, and poor sleep hygiene represent treatment targets for sleep problems in HIV patients. Sleep disturbances were common in this patient cohort, although largely undiagnosed and untreated. Sleep problems are linked to worse disease progression and increased cardiovascular mortality. Screening for sleep problems with a single question had high sensitivity and specificity. In those patients with self-reported sleep problems, screening for obstructive sleep apnea, depression, and sleep hygiene habits should be part of routine HIV care.

Sleep Apnea

sleep disparities

HIV

women’s sleep

insomnia

Details

Title: Subtitle: Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea
Creators: Jeydith Gutierrez - Department of Internal Medicine, University of Iowa Hospitals and Clinics and The Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Ellen M Tedaldi - Section of General Internal Medicine, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
Carl Armon - Cerner Corporation, Kansas City, MO, USA
Vaidahi Patel - Section of General Internal Medicine, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
Rachel Hart - Cerner Corporation, Kansas City, MO, USA
Kate Buchacz - Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
Resource Type: Journal article
Publication Details: SAGE open medicine, Vol.7, pp.2050312119842268-2050312119842268
DOI: 10.1177/2050312119842268
PMID: 31001423
PMCID: PMC6454647
NLM abbreviation: SAGE Open Med
ISSN: 2050-3121
eISSN: 2050-3121
Language: English
Date published: 2019
Academic Unit: General Internal Medicine; Internal Medicine
Record Identifier: 9984094521802771

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