Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China

作者:Huang, Xiaojie; Li, Huiqin; Meyers, Kathrine; Xia, Wei; Meng, Zhihao; Li, Chongxi; Bai, Jinsong; He, Shenghua; Cai, Weiping; Huang, Chengyu; Liu, Shuiqing; Wang, Hui; Ling, Xuemei; Ma, Ping; Tan, Daling; Wang, Fuxiang; Ruan, Lianguo; Zhao, Hongxin; Wei, Hongxia; Liu, Yanfen; Yu, Jianhua; Lu, Hongzhou; Wang, Min; Zhang, Tong; Chen, Hui*; Wu, Hao*
来源:Scientific Reports, 2017, 7(1): 3657.
DOI:10.1038/s41598-017-03968-3

摘要

This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95% CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR, 1.51; 95% CI, 1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.