May 10, 2012
Insomnia rates among those living with HIV and on treatment in the U.S. are no higher than that of the general population, despite sleep disturbances being a common complaint among people living with HIV, according to a study from the U.S. military. For HIV-infected individuals who were experiencing sleep disturbances, factors associated with insomnia included depression and increased waist size.
Researchers led by Nancy Crum-Cianflone, M.D., M.P.H., compared prevalence and factors associated with insomnia and daytime sleepiness among 193 HIV-infected and 50 HIV-uninfected individuals. Two-thirds of the HIV-infected group were taking meds, with 55% of the group having an undetectable viral load. It was not specified which medications they were taking. The average CD4+ cell count at the beginning of the study was 587.
Insomnia was reported in 46% of those living with HIV, compared with 38% among their HIV-uninfected counterparts. However, the researchers did not find this difference to be statistically significant -- i.e., it is possible that the difference is due to chance.
Sleep medication was used by 18% of those living with HIV and 16% of those without HIV. The average amount of sleep was 6.5 hours each night.
Daytime sleepiness was reported in 30% of the HIV-infected participants and 20% of the HIV-uninfected group. As with their insomnia findings, the study authors did not find these rates to be significantly different.
The researchers went on to assess the possible causes of insomnia and daytime sleepiness among the HIV-infected group. The factors that they found to be associated with insomnia were depression, increased waist size and fewer years of education.
"The strongest factor associated with insomnia among HIV-infected in our study was depression," observe the investigators. "This finding is consistent with other studies, and exemplifies that psychological morbidity is a major factor in insomnia among HIV-infected persons."
The authors believe this finding has implications for patient care: "treating depression might improve sleep quality, and the treatment of sleep disturbances may decrease the incidence of depression."
There was no evidence that HIV therapy or the use of any individual antiretroviral drugs were associated with insomnia.
While 19% of the HIV-infected participants were diagnosed with neurocognitive impairment, it was not associated with insomnia. The HIV-infected individuals with insomnia were three times more likely than those without insomnia to experience a decline in their daily activities.
"Prompt diagnosis and management of sleep disturbances are advocated and may improve quality of life," the researchers concluded.
Warren Tong is the research editor for TheBody.com and TheBodyPRO.com.
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