(PS13-D84) Understanding the Sleep-health Relationship in People Living with HIV: Sleep Actigraphy Results and HIV Health in an Urban HIV Clinic Sample

Objective

Sleep disturbances are prevalent and interfering in people living with HIV (PLWH). Lower quality sleep is known to be associated with problems such as poorer health-related quality of life and immune function in PWH. The current study aimed to examine the association between objective sleep/wake patterns measured via actigraphy with HIV outcomes.

Methods

Participants (N= 87) were recruited from an HIV clinic located in the Southeast United States. Participants wore actigraphy monitors for 5-8 days. Viral load and CD4 were obtained via medical chart review. Regression analyses predicting HIV RNA Viral Load (log transformed) and CD4 Count were employed with wake after sleep onset (WASO), sleep efficiency.

Results

The effect of sleep efficiency on viral load was statistically significant, b = 4.39, 95% CI(b)= [-0.06, -0.004], r-squared= 0.056, t (87) = -2.25, p = 0.03*. In a separate model, wake after sleep onset (WASO) was positively associated with viral load, and it was also statistically significant, b = 1.28, 95% CI(b)= [0.01, 0.68], R²= 0.05, t (87) = 2.05, p = 0.04*. In a multivariable model with both sleep efficiency and WASO entered, the associations to viral load were no longer significant, however, this was due to high correlation among both sleep efficiency and WASO. 

Conclusion

            The findings suggest that sleep, independent of medication adherence, is affecting viral load. Future studies should incorporate both objective and subjective measures of sleep, in relation to HIV outcomes to further understand their relationship. Implications of this study point to the need of intervening on sleep efficiency and wake after sleep onset to improve the health of PLWH.