Poor subjective sleep reported by people living with HIV is associated with impaired working memory

Abstract

Background. Poor sleep can undermine the health of people in general and may be especially disruptive to those with chronic conditions including HIV infection. Methods. Here, clinically well-described people living with HIV infection [PLWH] (74 men, 35 women) and healthy control (38 men, 35 women) participants were administered the Pittsburgh Sleep Quality Index (PSQI), which is a validated measure of subjective sleep with a global score ≥ 5 able to distinguish good from poor sleepers. In addition, participants completed neuropsychological tests assessing executive functioning, working memory, and learning and memory. Results. PLWH (6.8±3.7) had higher global PSQI scores than those of healthy controls (4.1±2.8): 39.7% of uninfected controls and 68.8% of PLWH had a PSQI ≥ 5 indicative of poor sleep. There were no relations between the global PSQI score and any evaluated variables among healthy-control individuals or with demographic or HIV-related variables in PLWH. Instead, a higher global PSQI score among PLWH was associated with worse “Quality of Life” measures including scores on the Global Assessment of Functioning (GAF, p = .0007), the Medical Outcomes Study survey (21-item short form, SF-21, p < .0001), and Activities of Daily Living-Instrumental (ADL-I, p = .0041); and more depressive symptoms as determined by the Beck Depression Index (BDI, p < .0001). Further, in PLWH, a higher global PSQI score was associated with poor performance on a working memory task, the digit backward span (p = .0036). In PLWH, the 5 variables together explained 32.3% of the global PSQI score variance; only 3 variables – the SF-21, BDI, and digit backward scores – explained 30.6% of the variance. Conclusions. To the extent that poor subjective sleep contributes to impaired working memory in HIV, we speculate that this impairment may be ameliorated by improved sleep health.