Associated factors of sleep quality in HIV-positive individuals

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From: Future Virology(Vol. 10, Issue 2)
Publisher: Future Medicine Ltd.
Document Type: Report
Length: 4,560 words
Lexile Measure: 1620L

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Author(s): Fatemeh Jabbari aff1 , Fatemeh Dabaghzadeh aff2 , Hossein Khalili [*] aff1 , Ladan Abbasian aff3


associated factors; HIV; sleep quality

Sleep disturbance is common in HIV-positive individuals [1-3 ]. Significant increase of slow wave sleep [4 ], alternations in sleep architecture [5 ], longer sleep onset latency, earlier morning awakening, more frequent awakenings during the night and reduced sleep efficiency have been reported frequently in these patients [6-9 ]. The prevalence of sleep disturbance in HIV-positive population was reported as high as 100% [1,10 ], while in general population the prevalence rate was 10-40% [3 ]. In addition, insomnia causes chronic fatigue, antiretroviral nonadherence and also affects the quality of life, physical and social functioning of HIV-positive patients [3 ]. Different factors including environmental, demographic, physiological and psychological factors affect sleep quality in this population [ 11-13 ]. There is a strong correlation between sleep disturbance and depression and anxiety. Depressed individuals usually are exposed to high level of sleep disturbance [6,14 ]. In addition, anxiety disorders can lead to delay sleep onset and reduced total sleep time [14 ]. During progression of HIV infection, sleep quality is affected by physical symptoms of HIV disease including fever, diarrhea, pain, cough, abdominal cramping, incontinence, itching, burning, night sweats and dyspnea [ 6 ]. Also many antiretroviral drugs especially efavirenz can lead to sleep disturbance, depression, anxiety and exacerbation of the physical symptom [ 3,15-17 ]. Other medications including benzodiazepines, barbiturates, narcotics and drugs used for treatment of opportunistic infections also can cause sleep disturbance [2 ]. In the present study, sleep quality and associated factors including demographic characteristics, anxiety-depression and physical morbidity have been evaluated in HIV-positive individuals.


This cross-sectional study was conducted in HIV clinic of Imam Khomeini Hospital, affiliated to Tehran University of Medical Sciences, Tehran, Iran from March 2013 to April 2014. The hospital's ethical committee approved the study protocol and all participants signed the study informed contest form. 200 individuals aged between 21 and 62 years, including 150 HIV-positive patients and 50 non-HIV-positive individuals (as control group), were included. HIV infection of the patients confirmed based on the ELISA and western-blot tests. Demographic data including sex, age, weight, routes of HIV transmission, education level, job, marital status, opportunistic infections and concomitant diseases of the subjects were collected. As it was reported that efavirenz can cause severe sleep disturbance [9 ], HIV-positive patients divided into three groups; received antiretroviral therapy (ART) including efavirenz, received ART without efavirenz and did not receive ART. Also for further analysis these patients were categorized into two groups; good and poor sleep quality. The validated Persian version of questionnaires including Pittsburgh Sleep Quality Index (PSQI) [18 ], Hospital Anxiety and Depression Scale (HADS) [19 ] and somatization subscale of Symptom Checklist-90 (SCL-90) [20,21 ] were used for evaluation of sleep quality, anxiety symptoms, depression symptoms and physiological factors of the included individuals respectively. PSQI is a self-report instrument based on the sleep quality measuring, in the range of 0-21. A greater amount of this value demonstrates a higher level of...

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Gale Document Number: GALE|A407934445