Burden of Insomnia and Associated Risk Factors in People Living with HIV/AIDS in a Tertiary Hospital in Sub-Saharan Africa

Abstract

Introduction: Several studies done in developed countries have reported that sleep disturbances occur frequently in people living with HIV/AIDS. However, there are limited data on the burden of insomnia among HIV infected persons in Sub-Saharan Africa. Aim: The aim of this study was to determine the prevalence and associated factors for Insomnia among HIV patients receiving care at a tertiary institution in south western Nigeria. Methods: A cross-sectional study was conducted among consecutive adult HIV patients attending an HIV clinic. HIV negative patients attending the general outpatient unit of the hospital were the control group. A semi-structured questionnaire was designed to obtain sociodemographic data and insomnia among the participants was assessed using the insomnia severity index questionnaire. The

Sleep disturbance and associated factors among Nigerian adults living with HIV in the dolutegravir era

“…Furthermore, incorporating cognitive and behavioral strategies that address depression and anxiety (Spies et al, 2013;Satre et al, 2019) into clinical practice may mitigate the contributions of these co-morbidities to sleep problems among PLWH, and addressing sleep health may improve mood disorders due to the reciprocal relationship between these conditions. While some reports (Oshinaike et al, 2014;Adeoti, 2018;Desalu et al, 2018) have indicated a link between poor sleep and certain HIV-related factors such as duration of HIV diagnosis and the type of ART, our study did not show any significant association between these HIV-related factors and sleep disturbance. Our findings mirror reports of Huang et al (2017).…”

“…Junqueira et al (2008) had described similar relationship among women living with HIV. Adeoti (2018) reported the odds of sleep problem as 2.5 times higher among depressed PLWH and Allavena et al (2016) observed even higher odds of 4.6 in similar No population. After adjusting for socio-demographic variables, the odds of having sleep disturbance were significantly higher among participants who reported either anxiety or depression.…”

“…A score of ≥5 implied the presence of depression. GAD-7 and PHQ-9 have good psychometric properties (Kroenke et al, 2001;Rutter and Brown, 2017) and have been validated for use among PLWH (Allavena et al, 2016;Yunusa et al, 2016;Adeoti, 2018).…”

“…For example, participants with anxiety (GAD ≥ 5) had a three-fold higher odds of sleep disturbance than those with no anxiety (GAD <5) (odds ratio [OR], 2.88; 95% CI, 1.25-6.62; p = 0.013). (Huang et al, 2017;Adeoti, 2018). The variation in prevalence may be attributable to differences in measurement tools, study periods and study sites.…”

“…Consequently, the prevalence of sleep disturbances in PLWH, reported as 29-97% (Reid and Dwyer, 2005;Taibi, 2012;Low et al, 2014;Awopeju et al, 2018) is remarkably higher than estimates of 3.9-40% found in the general population in lowincome countries (Stranges et al, 2012). Furthermore, sleep disturbance among PLWH is under-recognized by health care providers and underreported by patients (Desalu et al, 2018) just as the prevalence of poor sleep quality is between 20 and 59% (Oshinaike et al, 2014;Shittu et al, 2015;Yunusa et al, 2016;Adeoti, 2018;Awopeju et al, 2018;Desalu et al, 2018). Consequently, underreporting and inadequate recognition of sleep disturbance among PLWH may significantly worsen the quality of life.…”