This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.

译文

这项研究评估了中国大量HIV感染患者的患病率和与睡眠障碍相关的因素。在20个艾滋病诊所对接受抗逆转录病毒治疗的HIV感染患者进行了横断面研究。匹兹堡睡眠质量指数由受试者自行管理。收集了社会人口统计学特征,病史和与HIV相关的临床数据。4103患者有完整的数据进行分析。在43.1% 患者中观察到睡眠障碍。多变量分析的相关因素包括心理因素: 焦虑 (优势比 [OR],3.13; 95% 置信区间 [CI],2.44-4.00; P  <  0.001),抑郁 (OR,2.09; 95% CI,1.70-2.57; P  <  0.001),焦虑和抑郁 (OR,5.90; 95% CI,4.86-7.16; P  <  0.001); 社会人口统计学因素: MSM (OR,1.26; 95% CI,1.04-1.52; P   =   0.018),单身 (OR,1.45; 95% CI 1.21-1.74; P  <  0.001),高等教育 (OR, 1.25; 95% CI,1.03-1.53; P   =   0.025); 和临床因素: 次优依从性 (OR,1.51; 95% CI,1.23-1.85; P <  0.001),方案转换 (OR,1.94; 95% CI,1.12-3.35; P   =   0.018) 和抗抑郁药的使用 (或,1.98; 95% CI,1.47-2.67; P   =   0.044)。在这个庞大的中国人群中,睡眠障碍的患病率很高。相关因素似乎与心理和社会人口因素有关。卫生工作者可以考虑定期评估HIV感染患者的睡眠障碍,尤其是在HIV诊断后的前三个月,并推荐精神卫生服务,这可能会对治疗依从性产生积极影响。

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