Causes of sleep disturbance in human immunodeficiency virus-infected individuals: Is it depression or obstructive sleep apnea?

Saudi Med J. 2023 Dec;44(12):1248-1253. doi: 10.15537/smj.2023.44.12.20230390.

Abstract

Objectives: To examine the possible association of obstructive sleep apnea (OSA) and depression on sleep quality in people living with human immunodeficiency virus (PWLHIV).

Methods: Adult PWLHIV were included in this prospective, cross-sectional, case-control study. Our study was completed with 99 patients and 80 control subjects. To investigate sleep quality, the Pittsburgh Sleep Quality Scale and Stanford Sleepiness Scale were used; to determine the risk of OSA, the Berlin and STOP-BANG questionnaires were used; and to evaluate the existence and degree of depression, the Beck Depression Inventory was applied.

Results: Patients had significantly higher daytime sleepiness (p=0.002) and absent-mindedness (p=0.004). The rate of being able to concentrate on one's work was significantly higher in the control group compared with the patient group (p=0.000). More participants in the patient group had poor sleep quality (57% versus [vs.] 47.5%). The sleep quality score was significantly higher in the patient group (6.32 vs 5.23; p=0.032). Daytime dysfunction was significantly higher in the patient group (p=0.004). The rate of OSA risk was similar between the patient group and the control group on both the Berlin and STOP-BANG questionnaires (p=0.443 and p=0.581). Rates and numbers of depression the patient group were significantly higher (p=0.007).

Conclusion: The results suggest that depression may be the most likely cause of sleep disorders in PWLHIV, regardless of OSA.

Keywords: HIV; depression; obstructive sleep apnea; sleep disorders; sleep disturbance.

MeSH terms

  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Depression* / complications
  • HIV
  • Humans
  • Prospective Studies
  • Sleep Apnea, Obstructive* / complications
  • Sleep Quality
  • Surveys and Questionnaires