Loading…
Increased CD4 counts, pain and depression are correlates of lower sleep quality in treated HIV positive patients with low baseline CD4 counts
•South African treated HIV positive patients report poor sleep quality.•Poor sleep quality correlates with pain, depression, daytime sleepiness.•It is also associated with higher current CD4 counts/CD4 change from baseline.•This suggests a possible underlying immune activation disrupting sleep. Poor...
Saved in:
Published in: | Brain, behavior, and immunity behavior, and immunity, 2018-03, Vol.69, p.548-555 |
---|---|
Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | •South African treated HIV positive patients report poor sleep quality.•Poor sleep quality correlates with pain, depression, daytime sleepiness.•It is also associated with higher current CD4 counts/CD4 change from baseline.•This suggests a possible underlying immune activation disrupting sleep.
Poor sleep quality leads to increased immune activation and immune activation leads to worse sleep quality. South African HIV positive patients typically have delayed start of treatment, which has been associated with CD4+ effector T cells being more spontaneously activated in chronically treated patients. This cross-sectional study investigated whether subjective sleep quality was associated with CD4+ T lymphocyte reconstitution in treated South African HIV+ patients.
One hundred and thirty-nine treated HIV+ patients (109 F, age average (SD) = 43 (9)) were recruited from Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa. Participants completed questionnaires evaluating their subjective sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth sleepiness scale), pain, and depression severity (Beck Depression Inventory). Univariate and multivariate analyses were run to determine the correlates of sleep quality in this population.
Patients had been on antiretroviral treatment for about 4 years and had increased their CD4 counts from a median at baseline of 82 to 467 cells/µL. They had overall poor sleep quality (average (SD) PSQI = 7.7 (±5), 61% reporting PSQI > 5, a marker of lower sleep quality), 41% had clinical depression (average (SD) BDI = 17 (±12)) and 55% reported pain. In two separate multivariate analyses, both the overall CD4 count increase from baseline (p = 0.0006) and higher current CD4 counts (p = 0.0007) were associated with worse sleep quality, when adjusting for depression severity (p |
---|---|
ISSN: | 0889-1591 1090-2139 |
DOI: | 10.1016/j.bbi.2018.02.002 |