Causes of sleep disturbance in human immunodeficiency virus-infected individuals: Is it depression or obstructive sleep apnea?

To examine the possible association of obstructive sleep apnea (OSA) and depression on sleep quality in people living with human immunodeficiency virus (PWLHIV).

Adult PWLHIV were included in this prospective, cross-sectional, case-control study. Our study was completed with 99 patients and 80 control subjects. To investigate sleep quality, the Pittsburgh Sleep Quality Scale and Stanford Sleepiness Scale were used; to determine the risk of OSA, the Berlin and STOP-BANG questionnaires were used; and to evaluate the existence and degree of depression, the Beck Depression Inventory was applied.

Patients had significantly higher daytime sleepiness (p=0.002) and absent-mindedness (p=0.004). The rate of being able to concentrate on one's work was significantly higher in the control group compared with the patient group (p=0.000). More participants in the patient group had poor sleep quality (57% versus [vs.] 47.5%). The sleep quality score was significantly higher in the patient group (6.32 vs 5.23; p=0.032). Daytime dysfunction was significantly higher in the patient group (p=0.004). The rate of OSA risk was similar between the patient group and the control group on both the Berlin and STOP-BANG questionnaires (p=0.443 and p=0.581). Rates and numbers of depression the patient group were significantly higher (p=0.007).

The results suggest that depression may be the most likely cause of sleep disorders in PWLHIV, regardless of OSA.