Insomnia severity and depressive symptoms in people living with HIV and chronic pain: associations with opioid use

ABSTRACT

Chronic pain commonly occurs in people living with HIV (PLWH). Many PLWH in the United States obtain opioids for chronic pain management. Whether insomnia severity and depressive symptoms are exacerbated by chronic pain and opioid use in PLWH remains to be determined. This study examined insomnia severity and depressive symptoms in 85 PLWH with chronic pain and 35 PLWH without chronic pain. Among PLWH with chronic pain, reported opioid use was examined in relation to insomnia severity and depressive symptoms. PLWH with chronic pain reported significantly greater insomnia severity (p = .033) and depressive symptoms (p = .025) than PLWH without chronic pain. Among PLWH with chronic pain who reported opioid use (n = 36), insomnia severity was greater compared to those who denied opioid use (n = 49), even after controlling for pain severity and number of comorbidities (p = .026). Greater pain severity was significantly associated with greater insomnia severity (p < .001) and depressive symptoms (p = .048) among PLWH with chronic pain who reported opioid use. These associations were not significant among those PLWH with chronic pain who denied opioid use. Findings suggest that PLWH with chronic pain are likely to experience poor sleep and depressed mood. Furthermore, poor sleep was associated with opioid use among PLWH with chronic pain.

KEYWORDS:

• HIV
• chronic pain
• opioid use
• depression
• insomnia

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by a research supplement to promote diversity in health-related research (S.L.C.) under [grant number R01HL147603] (B.R.G.), as well as the Creative and Novel Ideas in HIV Research Program (B.R.G.) through a supplement from the National Institute of Allergy and Infectious Disease to the University of Alabama at Birmingham Center for AIDS Research under [grant number P30AI027767]. Additional support was also provided by the UAB Deep South Resource Center for Minority Aging Research under [grant number P30AG031054] (S.L.C.) from the National Institute on Aging and UAB CTSA [grant number UL1TR001417] from the National Center for Advancing Translational Sciences.