Fatigue and Sleep Disturbance Related to Perceived Stress in Chinese HIVPositive Individuals: A Mixed Methods Study

Abstract

Background Few studies of HIV+ individuals in China have examined the associations between HIV-related stress with sleep disturbance and fatigue, which are common complaints among people living with HIV/AIDS (PLWHA). We carried out this study to examine the relationships among perceived stress, sleep disturbance, and fatigue in PLWHA in China. Methods A mixed methods study design was used during data collection in Shanghai, China, from December 2009 to March 2010. Qualitative in-depth interviews were conducted with 19 HIV+ females. Additionally, cross-sectional audio computer-assisted self-interviews (ACASI) were conducted to collect quantitative data from a convenience sample of 107 HIV+ patients (84% were male) including the following scales: 1) Perceived Stress Scale for PLWHA, 2) General Sleep Disturbance Scale, and 3) Fatigue Scale. Results The major themes that emerged from the in-depth interviews were around life stress with HIV, sleep disturbance, and fatigue. Participants presented varying amounts of stress around worrying about whether to disclose their diagnosis and whether they might transmit the disease to their family. In addition, in the cross-sectional data, 40% of the participants reported clinically significant sleep disturbances (GSDS > 3) with an average of 3 nights of disturbed sleep in the past week (M=2.87, SD=1.21) and moderate fatigue severity (M=5.24, SD=2.27). In mediation analyses, the data suggests that the relationship between perceived stress and fatigue was largely (53%) mediated through sleep disturbance. Conclusions Chinese PLWHA described how stress had caused them to become sleepless and fatigued. The quantitative data also demonstrated significant levels of sleep disturbance and fatigue, where were due to perceived stress with HIV disease. A systematic self-management intervention to decrease perceived stress should be designed and implemented in mental health resource-limited settings such as China in order to reduce sleep disturbance and fatigue.

Transtornos Mentais Comuns estão associados a maior carga viral em Pessoas Vivendo com HIV

“…Another limitation is the impossibility of establishing a temporal relation of cause and effect between the evaluated variables. On the other hand, the results found are supported by previous studies 8, [12][13][14]16,17 , strengthening this way the associations found. Furthermore, due to the scarcity of data on the topic addressed here and the current situation of the HIV epidemic, studies of this nature are fundamental to raise hypotheses and provide subsidies for other types of study 31 .…”

Mechanisms Influencing Circadian Blood Pressure Patterns Among Individuals with HIV

“…For example, in 96 HIV+ individuals, the level of HIV trans-activator of transcription (tat) protein was significantly correlated with the circadian rhythm of systolic BP and with the Pittsburgh Quality Sleep Index and melatonin level [50•]. In addition, the heightened stress levels and disease-associated symptoms experienced by HIV+ individuals may lead to poor sleep quality and sleepdisordered breathing [74][75][76][77][78]. However, the effect of sleep quality on ABPM phenotypes in HIV+ individuals has not been evaluated.…”

A Psychosocial Intervention for Mental Health of People With Hiv (Plwh): A Literature Review

“…Although treatment progress is significantly influential, it remains a source of stress for many people and is associated with an increase in the level of depression. Depression is one of the most common comorbidities in HIV infection, with a prevalence of 20-37% among people living with HIV or 3 times higher than the general population and the incidence of anxiety disorders around 20% (3)(4).…”