Insomnia, Health, and Health-related Quality of Life in an Urban Clinic Sample of People Living with HIV/AIDS

ABSTRACT

Objective/Background

Insomnia is a prevalent and interfering comorbidity of HIV infection. Nearly 70% of people living with HIV/AIDS (PLWHA) experience symptoms of insomnia and associated distress. The current study examined the mechanisms of insomnia in HIV health status and health-related quality of life and explored behavioral pathways to explain relationships.

Participants

Participants (N = 103) were active patients in an HIV clinic located within a nonprofit, tertiary care hospital in a large, urban city in the Southeast United States.

Methods

Participants completed a clinical sleep interview and self-report assessments for adherence to antiretroviral medication, depression (PHQ-9), quality of life (ACTG-QOL), and relevant covariates. Viral load and CD4 were obtained via medical chart review.

Results

Insomnia affected 67% of the clinic sample. Insomnia symptoms were directly associated with poorer health-related quality of life (p<.001). Greater insomnia symptoms were also significantly associated with greater depressive symptoms [b =.495, S.E. =.061], poorer medication adherence [b = −.912, S.E. =.292], and worse health status measured by absolute CD4 count [b = −.011, S.E. =.005].

Conclusions

In this sample of PLWHA, insomnia was associated with poorer health-related quality of life and worse health status. Future research and practice should consider insomnia treatment for this population, as it could improve overall health and well-being.

Acknowledgments

Research reported in this paper was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number F31MH113481 (Rogers), 9K24DA040489 (Safren), and 5P30AI073961 (Pahwa). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This study was also supported by the Department of Psychology at the University of Miami.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institute of Allergy and Infectious Diseases [5P30AI073961]; National Institute of Mental Health [F31MH113481]; National Institute on Drug Abuse [9K24DA040489]; University of Miami.