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- Insomnia: "a persistent difficulty falling asleep, staying asleep, or non-restorative sleep associated with impaired daytime function" (American Academy of Sleep Medicine)
- Has been associated with poorer outcome in HIV because it adversely affects immune status, medication adherence, and is correlated with increased fatigue and comorbid psychiatric disorders (e.g., anxiety/depression) leading to lower quality of life
- Decreased cognitive performance (particularly on tasks of attention), frontal/executive functioning, and psychomotor/motor speed have been associated with sleep disruption in HIV+ individuals
- Limited literature on insomnia in HIV. Much of the literature discussed "sleep disturbance."
- Prevalence of sleep disturbance in HIV+ patients (29-97%) should be compared to sleep disturbance in general population (~33%), not prevalence of clinically significant insomnia in general population (~10%)
- Examples of sleep disturbance include daytime sleepiness, difficulty initiating sleep, nocturnal awakenings, and disrupted sleep architecture
- In a convenience sample of 290 HIV+ adults living, Lee et al. found the following:
- 45% slept < 6 hrs per night
- Difficulty falling asleep reported by 34%
- 56% had fragmented sleep according to actigraphy
- 30% were "good sleepers"
- Some correlates to sleep disturbance in HIV+ patients are:
- EFV has been well-documented to cause insomnia and other sleep disruptions, especially during early weeks of therapy
- Cessation of chronic use of alcohol or benzodiazepines often produces insomnia