Sleep Health and Quality in HIV-Affected Populations

Sleep disturbances represent a common and multifactorial challenge among people living with HIV, encompassing insomnia, fragmented sleep, restless legs syndrome and alterations in sleep architecture. Both the infection itself and antiretroviral therapy can contribute to poor sleep quality via direct neuroinflammatory effects, drug–drug interactions and psychosocial stressors. Socioeconomic factors, mental health comorbidities such as anxiety and depression, and HIV disease markers including low CD4 cell counts or high viral loads further exacerbate sleep disruption. Poor sleep has been linked to diminished daytime functioning, reduced adherence to medication, impaired immune recovery and lower quality of life. Global efforts now emphasise routine screening, standardised assessment tools and multidisciplinary management strategies to mitigate these adverse effects and optimise long-term outcomes for HIV-affected populations.

Research from Nature Portfolio

A large cross-sectional study in China involving over 4,000 patients on antiretroviral therapy reported that nearly half experienced clinically significant sleep disturbances. Psychological factors (anxiety, depression), demographic features (being single, higher education) and clinical aspects (suboptimal treatment adherence, regimen switches) emerged as key predictors. This work underlines the need for integrated mental health support and early sleep assessment following HIV diagnosis.

In a rural South African cohort of older adults, self-reported sleep duration averaged more than eight hours but poor sleep quality and restless sleep were common, especially among women and those with comorbid hypertension. Notably, untreated HIV infection was associated with more nocturnal awakenings than either HIV-negative status or antiretroviral-treated individuals, suggesting that viral control may have a beneficial effect on sleep patterns in ageing populations.

Sleep Health and Quality in HIV-Affected Populations publication trend

The graph below shows the total number of articles in sleep health and quality in hiv-affected populations across all publications each year (not limited to Nature Index journals).

Technical terms

Antiretroviral therapy (ART): Combination drug regimen used to suppress HIV replication and restore immune function.

Pittsburgh Sleep Quality Index (PSQI): Standardised questionnaire assessing sleep duration, disturbances and overall quality over one month.

Insomnia: Sleep disorder characterised by difficulty initiating or maintaining sleep despite adequate opportunity.

Restless legs syndrome (RLS): Sensorimotor neurological condition causing an uncontrollable urge to move the legs, often worsening at rest.

Sleep hygiene: Behavioural and environmental practices aimed at promoting consistent, restorative sleep.

References

1. The screening and management of sleep disturbances in people living with HIV: Delphi consensus. Journal of Sleep Research (2023).
2. Sleep quality and associated factors among adult people living with HIV on follow-up at Dessie Town Governmental Health Facilities Antiretroviral Therapy Clinics, Northeast, Ethiopia, 2020, a multicenter cross-sectional study. BMC Psychiatry (2023).
3. Prevalence and Risk Factors for Poor Sleep Quality in People Living with HIV: Preliminary Observations from an HIV Outpatient Clinic. Viruses (2023).
4. Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China. Scientific Reports (2017).
5. Associations between sleep parameters, non-communicable diseases, HIV status and medications in older, rural South Africans. Scientific Reports (2018).