Obstructive sleep apnoea among HIV patients

Abstract

The development of body weight gain and lipodystrophy due to antiretroviral therapy may lead to disturbances in sleep, particularly the obstructive sleep apnoea (OSA) syndrome. A retrospective review of the medical records of consecutively identified HIV-infected subjects who were diagnosed with OSA by overnight polysomnography between January 1, 2003 and December 31, 2004 was performed. Twelve HIV-infected subjects with OSA confirmed by polysomnography (total apnoea/hypopnoea index > or = 5) were identified. Daytime somnolence, fatigue, and snoring were the most common symptoms identified. Eleven (92%) subjects were overweight/obese, and seven (58%) had lipodystrophy. Eleven (92%) had a neck size > or =40.0 cm. Increased neck circumference, overweight or obese body mass index, and lipodystrophy are therefore potential risk factors for OSA among HIV patients. Clinicians caring for HIV patients with these characteristics should inquire about daytime somnolence, fatigue, and snoring and consider evaluation for a sleep-related disorder such as OSA. Overnight polysomnography can aid in the diagnosis of sleep disturbances.

Obstructive sleep apnea in 2 women with familial partial lipodystrophy due to a heterozygous LMNA R482Q mutation

“…Furthermore, obstructive sleep apnea has been reported in patients with acquired lipodystrophy syndromes, specifically partial lipodystrophy associated with HIV infection treated with highly active antiretroviral drugs. 7 No clear mechanism links familial partial lipodystrophy subtype 2 with obstructive sleep apnea, although both of the patients we have described were of normal weight but had markedly increased neck fat content, specifically in the region surrounding the trachea. This suggests that the association might be related to the repartitioning of adipose tissue that is characteristic of patients with this type of lipodystrophy.…”

Likelihood of obstructive sleep apnea in people living with HIV in Cameroon – preliminary findings

“…Compliance to HAART favors fat redistribution in PLWHA: visceral as well as lipodystrophy (Lo Re et al 2006;Kosmiski et al 2003). Brigham and collaborators (McNicholas 2009) demonstrated that PLWHA not on HAART with moderate to severe OSA have high circulating levels of inflammatory markers especially TNF-alpha, compared to those with no-to-mild OSA after adjustment for age, race, smoking status, obstructive lung disease and BMI.…”

“…OSA is usually associated with obesity (Gupta et al 2010;Resta et al 2001) and the onset of sleep apnea frequently follows a marked increase in body weight (Smith et al 1988). However, obesity alone is not essential for the development of OSA (Resta et al 2001;Lo et al 1998;Joy et al 2008;Lo Re et al 2006;Dorey-Stein et al 2008;Epstein et al 1995).…”

“…OSA has been observed by some authors to be common among persons living with HIV/AIDS (PLWHA) (Taibi 2013;Lo Re et al 2006;Dorey-Stein et al 2008;Epstein et al 1995). In this group of persons, body composition abnormalities such as subcutaneous fat wasting, central fat accumulation (Brown et al 2010), and adenotonsillar hypertrophy (Epstein et al 1995) are common; partly due to the viral infection and Highly Active Anti-Retroviral Therapy (HAART) (Lo et al 1998).…”

Overnight oximetry in African children with human immunodeficiency virus

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Aims Obstructive sleep apnoea (OSA) has been described in 2 small studies of adults with human immunodeficiency virus (HIV) and appears to be associated with higher body mass index1 and adenotonsillar hypertrophy 2. However, there are few data in children and the possibility of an association with cerebrovascular disease has not been addressed.

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