Miller School of Medicine, University of Miami, Miami, FL.
School of Medicine, Johns Hopkins University, Baltimore, MD.
Chest. 2023 Mar;163(3):687-696. doi: 10.1016/j.chest.2022.10.030. Epub 2022 Nov 4.
Data on the prevalence of sleep-disordered breathing (SDB) in people with HIV are limited. Moreover, whether the associations between SDB and age or BMI differ by HIV status is unknown.
Is SDB more prevalent in men with HIV than those without HIV, and do the predictors of SDB differ between the two groups?
Home polysomnography was used in the Multicenter AIDS Cohort Study to assess SDB prevalence in men with (n = 466; 92% virologically suppressed) and without (n = 370) HIV. SDB was defined using the oxygen desaturation index (ODI) and the apnea-hypopnea index (AHI), using four definitions: ≥ 5 events/h based on an ODI with a 3% (ODI) or 4% (ODI) oxygen desaturation, or an AHI with a 3% oxygen desaturation or EEG arousal (AHI) or with a 4% oxygen desaturation (AHI).
SDB prevalence was similar in men with and without HIV using the ODI and AHI definitions. However, SDB prevalence was higher in men with than without HIV using the ODI (55.9% vs 47.8%; P = .04) and the AHI definitions (57.9% vs 50.4%; P = .06). Mild and moderate SDB were more common in men with than without HIV. Associations between SDB prevalence and age, race, and BMI were similar in men with and without HIV. Among men with HIV, viral load, CD4 cell count, and use of antiretroviral medications were not associated with SDB prevalence.
SDB prevalence was high overall but greater in men with than without HIV using the ODI threshold definition. Efforts to diagnose SDB are warranted in people with HIV, given that SDB is associated with daytime sleepiness and impaired quality of life.
目前有关 HIV 感染者睡眠呼吸障碍（SDB）患病率的数据有限。此外，SDB 与年龄或 BMI 的相关性在 HIV 感染者和非感染者之间是否存在差异也尚不清楚。
HIV 感染者中 SDB 的患病率是否高于非 HIV 感染者，以及 SDB 的预测因素在两组之间是否存在差异？
多中心艾滋病队列研究采用家庭多导睡眠图评估了 HIV 感染者（n=466；92%病毒学抑制）和非感染者（n=370）的 SDB 患病率。SDB 采用氧减指数（ODI）和呼吸暂停低通气指数（AHI）定义，使用四种定义：基于 ODI（3%或 4%氧减）或 AHI（3%氧减或 EEG 觉醒）或 4%氧减（AHI）的≥5 次/小时事件；使用 ODI 或 AHI 定义。
使用 ODI 和 AHI 定义，HIV 感染者和非感染者的 SDB 患病率相似。然而，使用 ODI（55.9%比 47.8%；P=0.04）和 AHI（57.9%比 50.4%；P=0.06）定义时，HIV 感染者的 SDB 患病率更高。与非 HIV 感染者相比，HIV 感染者中轻度和中度 SDB 更为常见。SDB 患病率与年龄、种族和 BMI 的相关性在 HIV 感染者和非感染者中相似。在 HIV 感染者中，病毒载量、CD4 细胞计数和抗逆转录病毒药物的使用与 SDB 患病率无关。
总体而言，SDB 患病率较高，但使用 ODI 阈值定义时，HIV 感染者中 SDB 患病率更高。鉴于 SDB 与日间嗜睡和生活质量受损有关，HIV 感染者中需要进行 SDB 的诊断。
