Differences in sleep architecture between men living with and without HIV

Area of Science:

• Sleep Medicine
• Infectious Diseases
• Public Health

Background:

• HIV infection has evolved, with increased comorbidities like sleep disorders due to longer lifespans.
• Self-reported sleep issues are common in people with HIV, but objective sleep architecture differences were unknown.

Purpose of the Study:

• To objectively compare sleep architecture between men with and without HIV.
• To investigate the influence of sleep-disordered breathing (SDB) on sleep architecture in HIV.

Main Methods:

• Utilized polysomnography data from the Multicenter AIDS Cohort Study.
• Assessed total sleep time, sleep stage distribution, arousal index, and sleep stage transitions.
• Employed multivariable regression, adjusting for demographics and SDB severity.

Main Results:

• Men with HIV had similar total sleep time but lower sleep efficiency and more wake time after sleep onset compared to men without HIV.
• Sleep-disordered breathing (SDB) independently correlated with increased N1 sleep and decreased N2 and REM sleep.
• The combination of HIV and severe SDB resulted in the poorest sleep efficiency, highest N1 sleep, and least stable sleep stage transitions.

Conclusions:

• HIV is independently associated with altered sleep architecture, including reduced sleep efficiency and increased sleep stage instability.
• Sleep-disordered breathing significantly exacerbates these sleep disturbances in individuals with HIV.
• Further research is warranted on the health implications of disrupted sleep in the context of HIV and SDB.