Sleep satisfaction and cognitive complaints in Chinese middle-aged and older persons living with HIV: the mediating role of anxiety and fatigue

ABSTRACT

Middle-aged and older persons living with HIV (PLWH) suffer from sleep distress and cognitive disorders due to HIV infection and aging. We aim to explore the relationship between sleep satisfaction and cognitive complaints, and the mediating role of anxiety and fatigue in this relationship among middle-aged and older PLWH. We used data from a multicenter cross-sectional study in China (Shanghai, Kunming, Nanning, Hengyang, and Changning) conducted in 2017. The data analysis included 435 PLWH aged 45 years and over. Multiple linear regression models showed that worse sleep satisfaction was significantly associated with lower cognitive complaints after controlling for anxiety, fatigue, demographic variables, and clinical variables (β = −0.246, p < 0.01). Both anxiety and fatigue were significant partial mediators in the relationship between sleep satisfaction and cognitive complaints. The serial multiple mediation models of sleep satisfaction–anxiety (M1)–fatigue (M2)–cognitive complaints were supported and the alternative model of sleep satisfaction–fatigue (M2)–anxiety (M1)–cognitive complaints were both supported. Our study indicates that it is important to improve sleep quality to promote cognitive function among Chinese middle-aged and older PLWH. Prevention and treatment programs for sleep satisfaction and cognitive function should include the assessment and reduction of fatigue and anxiety.

KEYWORDS:

• HIV
• sleep satisfaction
• cognitive complaints
• anxiety
• fatigue
• aging

Acknowledgments

The authors would like to acknowledge all the staff who helped them complete this project: Lin Zhang and Hongzhou Lu from Shanghai Public Health Center Affiliated with Fudan University; Qingfen Liu from Yunnan Infectious Disease Special Hospital; Caiyun Wei from Nanning No.4 People’s Hospital; Lian Yang from Hengyang No.3 People’s Hospital; Dongning Zhao from the Changning Centers for Disease Control; and Yuquan Luan and Yanfen Fu from the School of Nursing, Dali University.

Disclosure statement

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

Additional information

Funding

This study was funded by the National Natural Science Foundation of China: (grant number 71673057) and the China Scholarship Council (grant number 201906100135).