Institute for Global Health, University College London.
Department of Infectious Disease, Imperial College London, London.
AIDS. 2021 Jun 1;35(7):1051-1060. doi: 10.1097/QAD.0000000000002852.
The aim of this study was to evaluate the agreement between self-reported sleep measures and insomnia with objectively measured sleep parameters in people with HIV (PWH) and HIV-negative individuals.
A cross-sectional analysis of PWH and lifestyle-similar HIV-negative individuals.
Self-reported measures included time spent in bed, sleep onset latency and a validated insomnia questionnaire. Objective measures were assessed via 7-days/nights of actigraphy data to determine average and intra-individual variability of several sleep measures (including time spent in bed and onset latency). Spearman's correlation coefficient and Cohen's κ were used to assess the agreement between self-reported and actigraphy-assessed measures. Associations between insomnia and actigraphy-assessed sleep parameters were evaluated using partial least-square discriminant analysis (PLS-DA).
We found fair correlation between self-reported and actigraphy-assessed time spent in bed in 342 PWH (rs = 0.46) and 119 HIV-negative individuals (rs = 0.48). Among PWH, the correlation did not differ by age, education, depressive symptoms and self-reported insomnia (all P > 0.05), but was stronger in men (P = 0.05) and in those with a BMI of at least 25 kg/m2 (P < 0.001). Agreement between self-reported and actigraphy-assessed sleep onset latency was poor in both PWH (κ = 0.002, P = 0.49) and HIV-negative individuals (κ = 0.009, P = 0.65). According to PLS-DA, self-reported insomnia most strongly correlated with intra-individual variability of sleep duration, movement index and efficiency.
We report poor-to-fair agreement between self-reported and actigraphy-assessed sleep measures in PWH. Insomnia symptoms correlated with regularity of sleep duration, quality and efficiency. These findings highlight the importance of both patient-reported and objective measures of daily sleep variation, for better understanding sleep disorders in PWH.
本研究旨在评估 HIV 感染者（PWH）和 HIV 阴性个体的自我报告睡眠测量值与客观测量睡眠参数之间的一致性。
对 PWH 和生活方式相似的 HIV 阴性个体进行横断面分析。
自我报告的测量包括卧床时间、入睡潜伏期和经过验证的失眠问卷。通过 7 天/夜的活动记录仪数据来评估客观测量，以确定几个睡眠测量值（包括卧床时间和潜伏期）的平均值和个体内变异性。使用 Spearman 相关系数和 Cohen's κ 评估自我报告和活动记录仪评估的测量值之间的一致性。使用偏最小二乘判别分析（PLS-DA）评估失眠与活动记录仪评估的睡眠参数之间的关联。
我们发现 342 名 PWH（rs=0.46）和 119 名 HIV 阴性个体（rs=0.48）的自我报告和活动记录仪评估的卧床时间之间存在中度相关性。在 PWH 中，这种相关性不受年龄、教育程度、抑郁症状和自我报告的失眠（所有 P>0.05）的影响，但在男性（P=0.05）和 BMI 至少为 25 kg/m2 的个体中更强（P<0.001）。PWH（κ=0.002，P=0.49）和 HIV 阴性个体（κ=0.009，P=0.65）中自我报告和活动记录仪评估的入睡潜伏期之间的一致性均较差。根据 PLS-DA，自我报告的失眠与睡眠持续时间、运动指数和效率的个体内变异性相关性最强。
我们报告了 PWH 中自我报告和活动记录仪评估的睡眠测量值之间的一致性差到中度。失眠症状与睡眠持续时间、质量和效率的规律性相关。这些发现强调了患者报告和客观测量日常睡眠变化的重要性，以更好地了解 PWH 的睡眠障碍。
