Borker Priya V, Smagula Stephen F, Sherman Julia, Morris Alison, Macatangay Bernard, Patel Sanjay R
Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Open Forum Infect Dis. 2025 Aug 21;12(9):ofaf498. doi: 10.1093/ofid/ofaf498. eCollection 2025 Sep.
People living with HIV (PLWH) commonly have sleep disturbances, but little is known about their habitual sleep patterns and rest-activity rhythms (RARs). We sought to compare sleep and RAR metrics between people living with and without HIV.
Adult participants with (n = 106) and without HIV (n = 105) underwent evaluation with 14 days of wrist actigraphy. PLWH were virally suppressed and on stable antiretroviral therapy for at least 1 year before evaluation. Sleep duration, timing, regularity, and RAR metrics were derived from actigraphy. Differences in sleep and RAR metrics by HIV status were compared using multivariable regression adjusting for age, sex, race, body mass index, education, employment, smoking, alcohol, and sleep apnea severity.
In adjusted analyses, PLWH had later timing of sleep and activity compared with those without HIV (sleep midpoint 38.9 ± 12.7 minutes later, = .003, acrophase 44.3 ± 13.1 minutes later, = .0009) and less consolidated nighttime sleep (sleep efficiency 2.4 ± 0.9% lower, = .007; daytime napping 10.5 ± 3.9 minutes greater, = .007). In addition, PLWH had less robust rhythms with more variable nightly sleep (standard deviation of nocturnal sleep duration 18.1 ± 5.3 minutes greater, = .0007; standard deviation of sleep midpoint 26.0 ± 7.8 minutes greater, = .001), lower RAR peak (relative amplitude 0.07 ± 0.02 lower, = .002), and less regular rhythm (pseudo- statistic 858 ± 426 lower, = .046; interdaily stability 0.06 ± 0.02 lower, = .003).
PLWH have delayed, less consolidated, and less robust sleep and RARs compared with those without HIV, suggesting intrinsic differences in circadian rhythms. Future research should evaluate the impact of these abnormalities on long-term health outcomes in PLWH.
人类免疫缺陷病毒感染者（PLWH）普遍存在睡眠障碍，但对他们的习惯性睡眠模式和休息-活动节律（RARs）了解甚少。我们试图比较感染和未感染HIV人群的睡眠和RAR指标。
106名感染HIV的成年参与者和105名未感染HIV的成年参与者接受了为期14天的腕部活动记录仪评估。PLWH在评估前病毒载量得到抑制且接受稳定的抗逆转录病毒治疗至少1年。睡眠时长、时间、规律性和RAR指标由活动记录仪得出。通过多变量回归比较HIV状态对睡眠和RAR指标的差异，并对年龄、性别、种族、体重指数、教育程度、就业情况、吸烟、饮酒和睡眠呼吸暂停严重程度进行校正。
在校正分析中，与未感染HIV的人群相比，PLWH的睡眠和活动时间更晚（睡眠中点晚38.9±12.7分钟，P = 0.003；活动高峰晚44.3±13.1分钟，P = 0.0009），夜间睡眠的巩固性更差（睡眠效率低2.4±0.9%，P = 0.007；白天小睡时间长10.5±3.9分钟，P = 0.007）。此外，PLWH的节律性较差，夜间睡眠变化更大（夜间睡眠时长标准差高18.1±5.3分钟，P = 0.0007；睡眠中点标准差高26.0±7.8分钟，P = 0.001），RAR峰值更低（相对振幅低0.07±0.02，P = 0.002），节律规律性更差（伪F统计量低858±426，P = 0.046；日间稳定性低0.06±0.02，P = 0.003）。
与未感染HIV的人群相比，PLWH的睡眠和RARs延迟、巩固性更差且节律性更弱，提示昼夜节律存在内在差异。未来研究应评估这些异常对PLWH长期健康结局的影响。
