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Sci Rep. 2017 Jun 16;7(1):3657. doi: 10.1038/s41598-017-03968-3.

Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China.

Author information

1
Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China.
2
Infectious Diseases Department, Yunnan AIDS Caring Center, Kunming, Yunnan, 650301, China.
3
The Aaron Diamond AIDS Research Center, New York, NY, 10016, United States.
4
Infectious Diseases Department, Longtan Hospital of Guangxi, Liuzhou, Guangxi, 545005, China.
5
Infectious Diseases Department, the Third People's Hospital of Kunming, Kunming, Yunnan, 650041, China.
6
Infectious Diseases Department, the Infectious Diseases Hospital of Chengdu, Chengdu, Sichuan, 610061, China.
7
Institute of Infectious Diseases, the Eighth People's Hospital of Guangzhou, Guangzhou, Guangdong, 510060, China.
8
Department of AIDS, Chongqing Infectious Disease Medical Center, Chongqing, 400039, China.
9
Department of Infectious Diseases, the Fifth People's Hospital of Guiyang, Guiyang, Guizhou, 550004, China.
10
Department of Clinical AIDS Research, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, 518020, China.
11
Department of Hematology, the Third People's Hospital of Hengyang, Hengyang, Hunan, 421000, China.
12
Department of Infectious Diseases, the Second People's Hospital of Tianjin, Tianjin, 300193, China.
13
Department of Infectious Diseases, the People's Hospital of Luzhai, Liuzhou, Guangxi, 545600, China.
14
Department of Infectious Diseases, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China.
15
Department of Infectious Diseases, Wuhan Medical Treatment Center, Wuhan, Hubei, 430023, China.
16
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
17
Department of Infectious Diseases, the Second Hospital of Nanjing Affiliated to Southeast University Medical College, Nanjing, Jiangsu, 210003, China.
18
Department of Infectious Diseases, the Fourth People's Hospital of Nanning, Nanning, Guangxi, 530023, China.
19
Department of Infectious Diseases, the Sixth People's Hospital of Hangzhou, Hangzhou, Jiangsu, 310023, China.
20
Department of Infectious Diseases, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, 200083, China.
21
Department of Infectious Diseases, the First People's Hospital of Changsha, Changsha, Hunan, 410005, China.
22
School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China. chenhui@ccmu.edu.cn.
23
Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China. whdoc@sina.com.

Abstract

This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.

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