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Sleep disturbances in children with human immunodeficiency virus infection
L S Franck1, L M Johnson, K Lee
1School of Nursing, University of California San Francisco, San Francisco, California 94143, USA. lfranck@itsa.ucsf.edu
Insights
Children with HIV experience more sleep disturbances and daytime fatigue than healthy peers. This highlights the need for further research into sleep patterns and interventions for pediatric HIV infection.
Area of Science:
- Pediatric Sleep Medicine
- Infectious Diseases
- Child Psychology
Background:
- Sleep disturbances and fatigue are prevalent in adults with Human Immunodeficiency Virus (HIV).
- Limited research exists on sleep patterns and fatigue in children and adolescents with HIV.
- Understanding these issues is crucial for comprehensive pediatric HIV care.
Purpose of the Study:
- To compare sleep patterns and fatigue levels in HIV-infected children and adolescents with their healthy, matched peers.
- To investigate the prevalence of sleep disturbances and daytime tiredness in pediatric HIV infection.
- To establish a baseline for future research and interventions.
Main Methods:
- A descriptive, comparative study conducted in participants' homes.
- Eighteen HIV-infected children (CDC classifications A, B, C) and 15 healthy children aged 6-18 years participated.
- Sleep patterns were assessed using wrist actigraphy and a validated symptom diary for fatigue over 3 days.
Main Results:
- HIV-infected children exhibited significantly increased wake time after sleep onset (13.55% vs 7.47%).
- They experienced more frequent and longer awakenings, and greater daytime napping and evening tiredness compared to controls.
- These findings indicate poorer sleep quality and increased fatigue in the HIV-infected group.
Conclusions:
- Sleep disturbances are a significant issue in children and adolescents with HIV, mirroring findings in adults.
- Further research is needed to fully characterize sleep disturbances and fatigue in pediatric HIV.
- Developing strategies to improve sleep is essential for enhancing the well-being of these children.
Objective:
To describe the sleep patterns and level of fatigue in children and adolescents (6-18 years of age) with HIV infection, compared with ethnic-, gender-, and age-matched healthy children in the home setting.
Design:
Descriptive, comparative.
Setting:
Conducted in each child's home environment.
Study Participants:
Eighteen HIV-infected and 15 noninfected children completed the study. The Centers for Disease Control and Prevention HIV classifications for the 18 HIV-infected children were: A (n = 7), B (n = 6), and C (n = 5).
Methods:
A symptom diary was developed using a previously validated fatigue assessment scale, modified for use with children. Content validity of the diary was established with a panel of 5 experts in child development and pediatric HIV disease. Children were asked to complete the diary each morning and evening for 3 days. Each child wore a wrist actigraph during the same period.
Results:
The HIV-infected children had significantly more wake time after sleep onset, compared with noninfected children (13.55% vs 7. 47%). The HIV-infected children had more awakenings (25.33 vs 16.71) and were awake for longer periods (3.01 vs 1.01 minutes), compared with noninfected children. By parent report, 7 HIV-infected children napped and 2 noninfected children napped, indicating greater daytime fatigue in the HIV-infected children. HIV-infected children also reported a greater level of evening tiredness (2.47 vs 1.8).
Conclusions:
The findings from this study suggest that sleep disturbances occur in HIV-infected children, similar to findings previously described in HIV-infected adults. Additional research is necessary to characterize the nature and patterns of sleep disturbance and fatigue related to pediatric HIV-infection, to assess the impact these may have on daily activities, and to develop strategies to improve sleep for these children.