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

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.

Automated summary

Insomnia is prevalent and interfering comorbidity of HIV infection, affecting nearly 70% of people living with HIV/AIDS. The study found that insomnia symptoms were associated with poorer health-related quality of life, greater depressive symptoms, poorer medication adherence, and worse health status in PLWHA. These findings suggest that insomnia treatment could improve overall health and well-being in this population.