School of Nursing, Fudan University, Shanghai, People's Republic of China.
Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, People's Republic of China.
AIDS Care. 2021 Jul;33(7):929-937. doi: 10.1080/09540121.2020.1844861. Epub 2021 Jan 23.
Middle-aged and older persons living with HIV (PLWH) suffer from sleep distress and cognitive disorders due to HIV infection and aging. We aim to explore the relationship between sleep satisfaction and cognitive complaints, and the mediating role of anxiety and fatigue in this relationship among middle-aged and older PLWH. We used data from a multicenter cross-sectional study in China (Shanghai, Kunming, Nanning, Hengyang, and Changning) conducted in 2017. The data analysis included 435 PLWH aged 45 years and over. Multiple linear regression models showed that worse sleep satisfaction was significantly associated with lower cognitive complaints after controlling for anxiety, fatigue, demographic variables, and clinical variables ( = -0.246, < 0.01). Both anxiety and fatigue were significant partial mediators in the relationship between sleep satisfaction and cognitive complaints. The serial multiple mediation models of sleep satisfaction-anxiety (M1)-fatigue (M2)-cognitive complaints were supported and the alternative model of sleep satisfaction-fatigue (M2)-anxiety (M1)-cognitive complaints were both supported. Our study indicates that it is important to improve sleep quality to promote cognitive function among Chinese middle-aged and older PLWH. Prevention and treatment programs for sleep satisfaction and cognitive function should include the assessment and reduction of fatigue and anxiety.
中老年 HIV 感染者（PLWH）由于 HIV 感染和衰老而遭受睡眠困扰和认知障碍。我们旨在探讨睡眠满意度与认知主诉之间的关系，以及焦虑和疲劳在中老年 PLWH 中对这种关系的中介作用。我们使用了 2017 年在中国（上海、昆明、南宁、衡阳和长宁）进行的一项多中心横断面研究的数据。数据分析包括 435 名 45 岁及以上的 PLWH。多线性回归模型显示，在控制焦虑、疲劳、人口统计学变量和临床变量后，较差的睡眠满意度与认知主诉较低显著相关（ = -0.246， < 0.01）。焦虑和疲劳都是睡眠满意度与认知主诉之间关系的重要部分中介。睡眠满意度-焦虑（M1）-疲劳（M2）-认知主诉的串联多重中介模型得到支持，睡眠满意度-疲劳（M2）-焦虑（M1）-认知主诉的替代模型也得到支持。我们的研究表明，改善睡眠质量对于促进中国中老年 PLWH 的认知功能非常重要。睡眠满意度和认知功能的预防和治疗方案应包括疲劳和焦虑的评估和减轻。
