Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China.
Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China.
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DOI：
10.1038/s41598-017-03968-3
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发表时间：
2017-06-16
影响因子：
4.6
通讯作者：
Wu H
中科院分区：
文献类型：
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作者：
Huang X;Li H;Meyers K;Xia W;Meng Z;Li C;Bai J;He S;Cai W;Huang C;Liu S;Wang H;Ling X;Ma P;Tan D;Wang F;Ruan L;Zhao H;Wei H;Liu Y;Yu J;Lu H;Wang M;Zhang T;Chen H;Wu H
本研究评估了中国大量hiv感染者中睡眠障碍的患病率和相关因素。在20个艾滋病诊所对接受抗逆转录病毒治疗的艾滋病毒感染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。收集社会人口学特征、病史和hiv相关临床资料。4103例患者有完整的数据供分析。43.1%的患者存在睡眠障碍。多变量分析的相关因素包括心理因素：焦虑（比值比[OR]， 3.13； 95%可信区间[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）；社会人口因素：男男性行为（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）；临床因素：次优依从性（OR,1.51; 95% CI, 1.23-1.85; P < 0.001）、方案切换（OR, 1.94; 95% CI, 1.12-3.35; P = 0.018）和抗抑郁药使用（OR, 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。卫生工作者可考虑定期评估艾滋病毒感染患者的睡眠障碍，特别是在艾滋病毒诊断后的头三个月，并考虑转诊精神卫生服务，这可能对坚持治疗产生积极影响。
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.