Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, USA.
J Clin Sleep Med. 2012 Feb 15;8(1):67-75. doi: 10.5664/jcsm.1666.
To characterize specific types of sleep problems experienced by adults with HIV.
The design was cross-sectional involving sleep questionnaires, diaries, and wrist actigraphy. The convenience sample included 290 adults living with HIV, 22-77 years of age. Measures included self-report for sleep onset latency, and wrist actigraphy estimates of total sleep time at night, wake after sleep onset, and daytime sleep.
Nearly half (45%) of the sample slept < 6 h per night. Difficulty falling asleep was reported by 34%, and 56% had fragmented sleep according to actigraphy; 20% had both problems, and 30% were good sleepers. Participants reporting difficulty falling asleep had actigraphy and clinical measures similar to the good sleepers, but subjectively they experienced greater sleep disturbance and symptom burden (particularly anxiety and morning fatigue) and reported more use of sleep medication. Participants with fragmented sleep reported low levels of sleep disturbance and symptom burden similar to the good sleepers, despite actigraphy measures indicating they obtained less sleep both at night and during the day. Sleep fragmentation was also associated with sociodemographic factors and slightly lower CD4+ T-cell counts. Participants reporting both sleep problems had actigraphy and clinical profiles similar to those who had only fragmented sleep, but their symptom experience was similar to participants with only sleep initiation difficulties.
Findings support the need for targeting efforts to improve sleep for the majority of adults living with HIV/AIDS and tailoring interventions to the specific type of sleep problem regardless of the person's clinical and demographic profile.
描述 HIV 感染者成人经历的特定类型的睡眠问题。
设计为横断面研究，包括睡眠问卷、日记和腕动描记法。方便样本包括 290 名年龄在 22-77 岁之间的 HIV 感染者。测量包括睡眠潜伏期的自我报告，以及腕动描记法估计夜间总睡眠时间、睡眠后觉醒和白天睡眠时间。
近一半（45%）的样本每晚睡眠时间<6 小时。34%的人报告入睡困难，56%的人根据腕动描记法存在睡眠片段化；20%的人同时存在这两个问题，30%的人睡眠良好。报告入睡困难的参与者的腕动描记法和临床测量结果与睡眠良好者相似，但他们主观上经历了更大的睡眠干扰和症状负担（特别是焦虑和晨乏），并报告更多使用睡眠药物。睡眠片段化的参与者报告的睡眠干扰和症状负担水平与睡眠良好者相似，尽管腕动描记法测量结果表明他们夜间和白天的睡眠时间都较少。睡眠片段化也与社会人口因素和稍低的 CD4+ T 细胞计数有关。报告同时存在两种睡眠问题的参与者的腕动描记法和临床特征与仅存在睡眠片段化的参与者相似，但他们的症状体验与仅存在睡眠起始困难的参与者相似。
研究结果支持有必要针对大多数 HIV/AIDS 感染者努力改善睡眠，并根据特定类型的睡眠问题进行干预，而不论患者的临床和人口统计学特征如何。
