Title:Prevalence of Risk Factors Associated With Poor Quality of Sleep in
People Living with HIV and the Correlation between Quality of Sleep and
Cd4+ T Lymphocyte Reconstitution: A Cross-Sectional Study from Turkey
Volume: 22
Issue: 3
Author(s): Ozge Eren Korkmaz*Figen Kaptan Aydoğmuş*
Affiliation:
- Izmır Katip Celebi University, Atatürk Education Research Hospital, Izmir, Turkey
- Izmır Katip Celebi University, Atatürk Education Research Hospital, Izmir, Turkey
Keywords:
HIV, Sleep quality, CD4 + T lymphocyte, sleep disorders in PLWH, chronic immune activation, inflammation, reconstitution rate.
Abstract:
Introduction: The prevalence of sleep disorders in people living with HIV (PLWH) is
higher than in the general population. Even if viral suppression is achieved with Antiretroviral
Therapy (ART), the chronic immune activation and increased inflammation due to immune reconstitution
persist. The aim of our study was to determine the prevalence of poor quality of sleep
(QoS) and associated risk factors in PLWH and to investigate the relationship between poor QoS
and CD4 T lymphocyte count and CD4 reconstitution.
Methods: PLWH ≥18 years old, attending for routine HIV monitoring were recruited. PLWH
with conditions that may affect their QoS (pregnant, hospitalized, malignancy, substance-alcohol
abuse, psychiatric disease or treatment, sleeping pill) were excluded. Pittsburgh Sleep Quality Index
(PSQI, score ≥5 indicates poor QoS), Epworth Sleepiness Scale (ESS, score ≥11 indicates daytime
sleepiness), and Beck Depression Scale (BDS, score ≥10 indicates clinical depression) were
applied. CD4+ T lymphocyte reconstitution (current-baseline CD4+ count) and CD4+ T lymphocyte
reconstitution rate [(current-baseline CD4+ count)/duration of HIV infection in years] were
calculated for PLWH on ART. Student t-test and Pearson’s chi-squared test were used for analysing
the data, and p<0.05 was considered significant.
Results: A total of 131 (15 newly diagnosed, 116 on ART for at least six months) PLWH were enrolled.
Poor QoS was detected in 60.3% of PLWH. When compared, the ratio was higher in newly
diagnosed PLWH (vs PLWH on ART, p>0,05). Daytime sleepiness in PLWH with poor Qos
(p=0.04) was significantly increased (vs good QoS). Clinical depression (p=0.001) was significantly
more common in PLWH with poor QoS (vs good QoS). Although statistically nonsignificant
(p>0,05), younger age, female sex, being single, homosexüel sexual preference, high income and
living with the family were associated with poor QoS. No association was found between the
ART regime and QoS. PLWH with poor QoS had a higher CD4+ T lymphocyte count (p>0,05), a
higher number of CD4+ T lymphocyte reconstitution (p<0.05), and a higher reconstitution rate
than PLWH with good QoS (p<0.05).
Conclusion: Prevalence of poor QoS was high in our cohort. Poor QoS was associated with CD4+
T lymphocyte reconstitution and reconstitution rate.
