Influence of nutritional status and gastrointestinal symptoms on sleep quality in people living with HIV

Abstract

Sleep problems are frequent among people living with HIV (PLWH). Recent studies have found that inadequate nutritional status and presence of gastrointestinal symptoms are associated with sleep problems. Therefore, the objective of the present study was to evaluate the influence of nutritional status and gastrointestinal symptoms on sleep quality in PLWH receiving antiretroviral therapy (ART). A cross-sectional study evaluating the influence of nutritional and gastrointestinal aspects on the quality of sleep in 307 PLWH (age ≥18 years) receiving ART seen at the Specialized Care Service of Santos (SP, Brazil) was carried out. The Pittsburgh Sleep Quality Index (PSQI), body mass index and three questions from the Self-Reporting Questionnaire (SRQ-20) were used. Generalized linear models adjusted for gender, age, time in use of antiretrovirals, viral load, CD4+ T-lymphocyte cell count and CD4/CD8 ratio were built. Results showed that body mass index did not affect sleep quality. However, the interaction between poor appetite and not having poor digestion and uncomfortable feelings in the stomach negatively influenced sleep quality. The interaction of the three symptoms evaluated also affected sleep quality. Gastrointestinal symptoms were associated with reduced sleep quality, but there was no influence of BMI. Although the etiology of this relationship is unclear, there seems to be an important association between sleep quality, immune function and gastrointestinal disorders.

Sleep Disturbance in the Context of HIV: A Concept Analysis

“…The third antecedent, physical symptoms, includes fatigue ( Chenxi et al, 2019 ; Han et al, 2021 ; Voss et al, 2021 ), pain ( Nogueira et al, 2019 ; Redman et al, 2018 ; Sabin et al, 2020 ), apnea ( Chen et al, 2021 ; Gutierrez et al, 2019 ), gastrointestinal symptoms ( Nogueira et al, 2019 ), and nocturnal sweats ( Thorarinsdottir et al, 2019 ). The fourth antecedent of sleep disturbance is the side effects of the ARV therapy ( González-Tomé et al, 2018 ; Ren et al, 2018 ; Shikuma et al, 2018 ; Venkataraman et al, 2021 ), and the fifth antecedent is social factors, including family and social support ( Bedaso et al, 2020 ; Ren et al, 2018 ), internalized HIV stigma ( Fekete et al, 2018 ), unsatisfactory lifestyles ( dos Santos et al, 2018 ), low-income ( Yan et al, 2021 ), unemployment ( Najafi et al, 2021 ), and behavioral risk factors ( Costa et al, 2019 ; Downing et al, 2020 ; Ogunbajo et al, 2020 ).…”

Development of a Clinic Screening Tool to Identify Burdensome Health-Related Issues Affecting People Living With HIV in Spain

“…The highest covariances were found between the physical symptoms dimension and the dimensions of emotional distress, sleep/fatigue, and cognitive problems. Several studies have found relationships between these issues ( Muñoz-Moreno et al, 2014 ; Tedaldi et al, 2015 ; Uebelacker et al, 2015 ; Allavena et al, 2016 ; Redman et al, 2018 ; Ren et al, 2018 ; Nogueira et al, 2019 ; Sabin et al, 2020 ). The size of the covariances suggests that these four dimensions could be grouped in a second-order latent dimension that encompasses physical, emotional and cognitive concerns.…”