Sleep Disturbance in the Context of HIV: A Concept Analysis

Abstract

Due to the differing definitions of the concept of sleep disturbance among people living with human immunodeficiency virus (HIV), reviewers in this area have not reached any firm conclusions. The study aimed to clarify and provide a stronger foundation for the definition of sleep disturbance in the context of HIV to enhance the concept’s development. Following Beth Rodgers’ concept analysis guidelines, two leading databases were searched, and 73 articles were used for this concept analysis. The attributes, surrogate terms, antecedents, and consequences of sleep disturbance have been identified using thematic analysis. In this analysis, two main attributes of sleep disturbance in the context of HIV were identified: a) subjective measures, including reduced total sleep time, difficulty falling asleep, nighttime and early morning awakenings, feeling sleepy and poorly rested after a night’s sleep, frequent arousals, and irritability, and b) objective measures, including changes in sleep architecture and sleep continuity. Five antecedents of sleep disturbance in the context of HIV were identified. Meanwhile, the consequences of sleep disturbance in HIV are listed based on the frequency the points occur within the reviewed articles. The list is as follows: fatigue and pain; reduced neurocognitive functions; reduced health outcome and quality of life; poor anti-retroviral (ARV) therapy adherence; daytime sleepiness; depression, anxiety, and maladaptive coping; increased disease progression and cardiovascular mortality; and social phobia, living arrangement and sexual dysfunction. An improved understanding of sleep disturbance in the context of HIV will be beneficial in directing analysts to develop research plans. At the same time, the knowledge gaps identified in the analysis provided a solid basis for further study intending to fill in these gaps.

Sleep quality, social rhythms, and depression among people living with HIV: a path analysis based on social zeitgeber theory

“…The current study attempted to investigate a theoretically plausible link by identifying predictor variables of sleep in PLWH, including social rhythms, depression, social support, and coping styles. Based on the social zeitgeber theory and existing evidence, we propose the following four hypotheses ( 1 ): Social rhythms directly predict sleep quality ( 2 ), social support and coping styles (active coping, passive coping) directly predict social rhythms ( 3 ), social support and coping styles (active coping, passive coping) indirectly predict sleep quality through social rhythms, and ( 4 ) there was a bidirectional predictive association between sleep and depression. The hypothetical model is presented in Figure 1 .…”

“…A meta-analysis showed that the prevalence of selfreported sleep disturbances in PLWH was 58% (1). The sleep disturbances reported by PLWH mainly included reduced total sleep time, difficulty falling asleep, difficulty maintaining sleep, sleep reinitiation disorder, daytime dysfunction, excessive dreaming, and irritability (2)(3)(4). Sleep disturbances can contribute to a series of adverse consequences for PLWH, such as greater depressive symptoms (5), poorer health-related quality of life (6), increased risk of incident cardiovascular disease (7), lower HIV medication adherence, and self-reported increased HIV symptom severity (8).…”