Sleep Disturbances in HIV Infection and their Biological Basis

O'Brien, Katie, Riddell, Natalie, Xavier Gomez-Olivé, Xavier, Rae, Dale, Scheuermaier, Karine and von Schantz, Malcolm (2021) Sleep Disturbances in HIV Infection and their Biological Basis. Sleep Medicine Reviews. p. 101571. ISSN 1087-0792 (In Press)

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Official URL: https://doi.org/10.1016/j.smrv.2021.101571

Abstract

Antiretroviral therapy has significantly reduced morbidity and mortality in people living with HIV (PLWH). However, a direct consequence of higher survival is the development of ageing-related co-morbidities that have considerable potential to affect quality of life. Sleep disturbances in PLWH are a significant source of morbidity. A meta-analysis has estimated the prevalence of self-reported sleep disturbances in PLWH to be 58%, with commonly identified disturbances including insomnia, obstructive sleep apnoea and poor sleep quality. Not only do sleep disturbances impair daytime functioning, but chronic sleep disruption also associates with metabolic dysregulation and cardiometabolic disease. Therefore, an understanding of the pathogenesis of sleep disturbances in PLWH is important for reducing morbidity and improving quality of life. Several pathophysiological processes in HIV infection may cause sleep-wake dysregulation. In early infection stages, immunological changes such as expression of sleep-promoting cytokines could mediate sleep disturbances. Long term, chronic immune activation, in addition to side effects of antiretroviral therapy, may impact sleep homeostasis more severely, for example through increasing the risk of obstructive sleep apnoea. These sleep disturbances may further contribute to an inflammatory state, due to the bi-directional relationship between sleep and immunity. In summary, further elucidating the link between HIV, immune activation, and sleep is an underexplored avenue for minimising population morbidity and mortality.

Item Type: Article
Additional Information: Funding information: This work was supported by a Newton Fellowship from the Academy of Medical Sciences to FXGO and MvS.
Uncontrolled Keywords: AIDS, Antiretroviral treatment, Cellular immunity, Dopamine, Global health, Glutamate, HIV-associated neurocognitive disorders, Humoral immunity, Human immunodeficiency virus
Subjects: A900 Others in Medicine and Dentistry
B900 Others in Subjects allied to Medicine
C800 Psychology
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: Rachel Branson
Date Deposited: 05 Nov 2021 11:59
Last Modified: 01 Dec 2021 10:30
URI: http://nrl.northumbria.ac.uk/id/eprint/47646

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