Abstract:
Sleep disturbance is common among persons living with HIV (PLWH)
causing significant health impacts. Nigeria recently switched from efavirenz
to dolutegravir (DTG) for first-line antiretroviral therapy (ART). This study
aimed to assess the prevalence of sleep disturbance and to determine factors
associated with sleep disturbance among treatment-experienced PLWH.
Using a cross-sectional study design and systematic random sampling, 300
participants were recruited from the Infectious Diseases Institute, Ibadan,
Nigeria (IDI). Interviewer administered questionnaire was used to collect
data regarding sociodemographic, sleep disturbance (Pittsburgh Sleep Quality
Index; PSQI), depression (Patient Health Questionnaire; PHQ-9), anxiety
(Generalized Anxiety Disorder-7; GAD-7), and psychoactive substance use.
HIV-specific data were retrieved from IDI’s medical records. The relationship
between the PSQI score and the scores on the PHQ-9 and GAD-7 were
explored with the Pearson correlation coe cient. Chi-square global tests of
independence were used to assess factors associated with sleep disturbance
and a multivariable binary logistic model was used to determine independent
predictors of sleep disturbance. The mean age of the sample was 44.5 ± 11.4
(years), the average duration of HIV diagnosis was 8.13 ± 5.33 (years) and the
majority were on DTG-based regimens (95%). Depression and anxiety were
present in 14 and 17.3%, respectively. Prevalence of sleep disturbance (PSQI
score of 6 ormore) was 21.7%. Higher PSQI scores were associated with higher
PHQ-9 scores (r = 0.526; p < 0.001) and higher GAD-7 scores (r = 0.529;
p < 0.001). Sleep disturbance was associated with age ($
2 = 4.483, p = 0.038),
marital status ($
2 = 7.187, p < 0.01), depression ($
2 = 46.589, p < 0.001),
and anxiety ($
2 = 38.379, p < 0.001). There was no significant association
between sleep disturbance and HIV clinical stage at diagnosis, virological
suppression status, and ART regimen type (p > 0.05), whereas tea intake was
associated with an absence of sleep disturbance ($
2 = 6.334, p < 0.014). Age(>45 years), depression and anxiety were associated with higher odds of sleep
disturbance among PLWH. Sleep disturbance remains common among PLWH
in the DTG era. Depression and anxiety are significant factors associated with
sleep disturbance. Assessing these factors in future studies may improve the
sleep health of PLWH.
