Cross-sectional comparison of various sleep disturbances among sex- and age-matched HIV-infected versus HIV-uninfected individuals in China.

Objective/background: This study assessed the prevalence and correlates of various sleep disturbances in HIV-infected patients compared to sex- and age-frequency-matched HIV-uninfected controls in China.

Methods: This cross-sectional analysis included 1469 HIV-infected cases and 2938 HIV-uninfected controls. Insomnia symptoms, poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] >5) as well as their specific domains, were assessed.

Results: Prevalence of insomnia symptoms, poor sleep quality, and long sleep duration were higher in HIV-infected vs uninfected participants (23.7% vs 19.8%, 24.1% vs 19.9%, and16.1% vs 8.7%, respectively; all p < 0.05), and remained significant after adjusting for age, sex and education. An Age-stratified analysis showed that such differences were significant only at ages 18-29 and 30-44 years for insomnia symptoms and poor sleep quality long sleep duration was significant across all age groups. Among HIV-infected patients, multivariate analysis indicated that older age, depressive symptoms and frailty score were the most consistent variables associated with sleep disorders (ie, insomnia symptoms, poor sleep quality, short and long sleep durations), as well as all associations (if significant) were positive, excluding the negative associations of older age and depressive symptoms with short sleep duration. Regarding HIV-specific factors, only current CD4 cell count ≥500 cells/μL was negatively associated with insomnia symptoms.

Conclusions: The impact of HIV infection on sleep disturbances may differ across age groups and are more pronounced among young adults. Additionally, the phenomenon of prolonged sleep duration among HIV-infected patients should be noted, and its link to poor physical health warrants further investigation.