Abstract
A descriptive, correlational design was used to examine the associations of sleep quality and stage of illness with health-related quality of life (HRQOL) in HIV-infected African-American women. Participants were recruited from 12 health clinics and AIDS service organizations (ASO) in Georgia, North Carolina, and South Carolina. The sample consisted of 144 African-American women who ranged in age from 20 to 48 years (m=34.8, SD=6.8). The Pittsburgh Sleep Quality Index (PSQI) and the Medical Outcomes Short-Form Health Survey (SF-36) were administered. Participants were categorized as good sleepers (PSQI global score ≥7) or poor sleepers (PSQI global score ≥ 7) using the median global sleep quality score. Differences in HRQOL between good and poor sleepers, as measured by the SF-36, were tested using MANOVA. Good sleepers scored significantly higher (p < 0.0001) for each SF-36 quality of life dimension and the mental and physical health summary scores. Multiple regression analysis indicated that sleep quality is associated with HRQOL, independent of the individual’s stage of illness, more so with mental HRQOL than with physical HRQOL. The results suggest that treatment for poor sleep quality should be a primary concern for the treatment of HIV infection and a means for improving HRQOL.
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FL Cohen CE Ferrans V Vizgirda V Kunkle L. Cloninger (1996) ArticleTitleSleep in men and women infected with human immunodeficiency virus Holist Nurs Pract 10 IssueID4 33–43 Occurrence Handle1:STN:280:BymA28%2FptV0%3D
SE Norman AD. Chediak (1992) ArticleTitleLongitudinal analysis of sleep disturbances in HIV-infected men Sleep Res 21 304
K Walker A McGown M Jantos J. Anson (1997) ArticleTitleFatigue, depression, and quality of life in HIV-positive men J Psychosoc Nurs Ment Health Serv 35 IssueID9 32–40 Occurrence Handle1:STN:280:ByiH2czmslU%3D
IB Wilson PD. Cleary (1997) ArticleTitleClinical predictors of declines in physical functioning in persons with AIDS: results of a longitudinal study J Acquir Immune Defic Syndr Hum Retrovirol 16 IssueID5 343–349 Occurrence Handle1:STN:280:DyaK1c%2FotVGjsw%3D%3D Occurrence Handle9420312
IB Wilson PD. Cleary (1996) ArticleTitleClinical predictors of functioning in persons with acquired immunodeficiency syndrome Med Care 34 IssueID6 610–623 Occurrence Handle1:STN:280:BymB2Mfjs1Q%3D Occurrence Handle8656726
ML Rubinstein PA. Selwyn (1998) ArticleTitleHigh prevalence of insomnia in an outpatient population with HIV infection J Acquir Immune Defic Syndr Hum Retrovirol. 19 IssueID3 260–265 Occurrence Handle1:STN:280:DyaK1M%2FhvFWisQ%3D%3D Occurrence Handle9803968
GA Hand KD Phillips RL Sowell M Rojas J. Becker (2003) ArticleTitlePrevalence of poor sleep quality in a HIV+ population of Americans J S C Med Assoc. 99 201–205
SE Norman AD Chediak C Freeman etal. (1992) ArticleTitleSleep disturbances in men with asymptomatic human immunodeficiency (HIV) infection Sleep 15 IssueID2 150–155 Occurrence Handle1:STN:280:By2B2MzpsVQ%3D Occurrence Handle1579789
SE Norman AD Chediak M Kiel MA. Cohn (1990) ArticleTitleSleep disturbances in HIV-infected homosexual men AIDS. 4 IssueID8 775–781 Occurrence Handle1:STN:280:By6D1czptVI%3D Occurrence Handle2261133
SE Norman L Resnick MA Cohn R Duara J Herbst JR. Berger (1988) ArticleTitleSleep disturbances in HIV-seropositive patients JAMA. 260 IssueID7 922 Occurrence Handle1:STN:280:BieB1cnps1U%3D
AA Moeller M Wiegand M Oechsner JC Krieg F Holsboer C. Emminger (1992) ArticleTitleEffects of zidovudine on EEG sleep in HIV-infected men J Acquir Immune Defic Syndr 5 IssueID6 636–637 Occurrence Handle1:STN:280:By2B28bht1U%3D Occurrence Handle1588499
S Kubicki H Henkes D Alm et al. (1989) ArticleTitle[Polygraphic sleep data in AIDS patients] EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 20 IssueID4 288–294 Occurrence Handle1:STN:280:By%2BC3cjot1E%3D Occurrence Handle2514088
DF Darko JA McCutchan DF Kripke JC Gillin S. Golshan (1992) ArticleTitleFatigue, sleep disturbance, disability, and indices of progression of HIV infection Am J Psychiatry 149 IssueID4 514–520 Occurrence Handle1:STN:280:By2B3cnlt1w%3D Occurrence Handle1554037
KA Lee CJ Portillo H. Miramontes (2001) ArticleTitleThe influence of sleep and activity patterns on fatigue in women with HIV/AIDS J Assoc Nurses AIDS Care. 12 IssueIDSuppl 19–27 Occurrence Handle11563234
KM Nokes J. Kendrew (2001) ArticleTitleCorrelates of sleep quality in persons with HIV disease J Assoc Nurses AIDS Care 12 IssueID1 17–22 Occurrence Handle1:STN:280:DC%2BD3M3ht1Cqtg%3D%3D Occurrence Handle11211669
M Manocchia S Keller JE. Ware (2001) ArticleTitleSleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill Qual Life Res. 10 IssueID4 331–345 Occurrence Handle1:STN:280:DC%2BD38%2FjsVymtA%3D%3D Occurrence Handle11763246
CDC. (2002) ArticleTitleHIV/AIDS Surveillance Report Centers for Disease Control and Prevention 14 1–48
DL Bliwise AC King RB Harris WL. Haskell (1992) ArticleTitlePrevalence of self-reported poor sleep in a healthy population aged 50–65 Soc Sci Med. 34 IssueID1 49–55 Occurrence Handle1:STN:280:By2C2M7htVM%3D Occurrence Handle1738856
DJ Buysse CF Reynolds SuffixIII TH Monk CC Hoch AL Yeager DJ. Kupfer (1991) ArticleTitleQuantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI) Sleep. 14 IssueID4 331–338 Occurrence Handle1:STN:280:By2D2MzpsVM%3D Occurrence Handle1947597
DJ Buysse CF Reynolds SuffixIII TH Monk SR Berman DJ. Kupfer (1989) ArticleTitleThe Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research Psychiatry Res. 28 IssueID2 193–213 Occurrence Handle1:STN:280:BiaA3MnhsFQ%3D Occurrence Handle2748771
J Backhaus K Junghanns A Broocks D Riemann F. Hohagen (2002) ArticleTitleTest-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia J Psychosom Res. 53 IssueID3 737–740 Occurrence Handle12217446
JS Carpenter MA. Andrykowski (1998) ArticleTitlePsychometric evaluation of the Pittsburgh Sleep Quality Index J Psychosom Res. 45 IssueID1 Spec No 5–13 Occurrence Handle1:STN:280:DyaK1czosFyjtg%3D%3D Occurrence Handle9720850
R Murri A Ammassari M Fantoni etal. (1997) ArticleTitleDisease-related factors associated with health-related quality of life in people with nonadvanced HIV disease assessed using an Italian version of the MOS-HIV Health Survey J Acquir Immune Defic Syndr Hum Retrovirol. 16 IssueID5 350–356 Occurrence Handle1:STN:280:DyaK1c%2FotVGjsA%3D%3D Occurrence Handle9420313
WC Holmes JA. Shea (1999) ArticleTitleTwo approaches to measuring quality of life in the HIV/AIDS population: HAT-QoL and MOS-HIV Qual Life Res. 8 IssueID6 515–527 Occurrence Handle1:STN:280:DC%2BD3c%2Fhs1GrsQ%3D%3D Occurrence Handle10548867
Panel on clinical practices for treatment of HIV infection eal. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. NIH AIDS Info; 2003
AW Wu HR Rubin WC Mathews et al. (1991) ArticleTitleA health status questionnaire using 30 items from the Medical Outcomes Study Preliminary validation in persons with early HIV infection. Med Care. 29 IssueID8 786–798 Occurrence Handle1:STN:280:By6A2c3is1I%3D
CA McHorney JE Ware SuffixJr. AE. Raczek (1993) ArticleTitleThe MOS 36-Item Short-Form Health Survey (SF-36): II Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care . 31 IssueID3 247–263 Occurrence Handle1:STN:280:ByyC1MnisVI%3D
Ware JE, Snow KK, Kosinski M. SF-36 Health Survey: Manual and Interpretation Guide. Lincoln, RI: QualityMetric Incorporated, 2000
J Shahriar T Delate RD Hays SJ. Coons (2003) ArticleTitleCommentary on using the SF-36 or MOS-HIV in studies of persons with HIV disease Health Qual Life Outcomes. 1 IssueID1 25 Occurrence Handle12914664
BG Tabachnick LS. Fidell (1989) Using Multivariate Statistics EditionNumber2 Harper Collins New York
MS Aldrich AE Rogers K. Angell (1998) ArticleTitleExcessive daytime sleepiness as a presenting manifestation of HIV infection Sleep Res. 318 250
AA Moeller M Oechsner HC Backmund M Popescu C Emminger F. Holsboer (1991) ArticleTitleSelf-reported sleep quality in HIV infection: correlation to the stage of infection and zidovudine therapy J Acquir Immune Defic Syndr. 4 IssueID10 1000–1003 Occurrence Handle1:STN:280:By6A28nlsF0%3D Occurrence Handle1890592
DF Dinges SD Douglas S Hamarman L Zaugg S. Kapoor (1995) ArticleTitleSleep deprivation and human immune function Adv Neuroimmunol. 5 IssueID2 97–110 Occurrence Handle1:CAS:528:DyaK2MXotlyhs7w%3D Occurrence Handle7496616
DF Darko MR Irwin SC Risch JC. Gillin (1992) ArticleTitlePlasma beta-endorphin and natural killer cell activity in major depression: a preliminary study Psychiatry Res. 43 IssueID2 111–119 Occurrence Handle1:CAS:528:DyaK3sXpvFGlug%3D%3D Occurrence Handle1410068
M. Irwin (2002) ArticleTitleEffects of sleep and sleep loss on immunity and cytokines Brain Behav Immun. 16 IssueID5 503–512 Occurrence Handle1:CAS:528:DC%2BD38XotFSgtLg%3D Occurrence Handle12401464
M Irwin A Mascovich JC Gillin R Willoughby J Pike TL. Smith (1994) ArticleTitlePartial sleep deprivation reduces natural killer cell activity in humans Psychosom Med. 56 IssueID6 493–498 Occurrence Handle1:STN:280:ByqC2srovFM%3D Occurrence Handle7871104
M Irwin J Thompson C Miller JC Gillin M. Ziegler (1999) ArticleTitleEffects of sleep and sleep deprivation on catecholamine and interleukin-2 levels in humans: clinical implications J Clin Endocrinol Metab. 84 IssueID6 1979–1985 Occurrence Handle1:CAS:528:DyaK1MXjs1Ohsro%3D Occurrence Handle10372697
M Irwin J McClintick C Costlow M Fortner J White JC. Gillin (1996) ArticleTitlePartial night sleep deprivation reduces natural killer and cellular immune responses in humans FASEB J. 10 IssueID5 643–653 Occurrence Handle1:CAS:528:DyaK28XivVKlsrY%3D Occurrence Handle8621064
L Redwine J Dang M Hall M. Irwin (2003) ArticleTitleDisordered sleep, nocturnal cytokines, and immunity in alcoholics Psychosom Med. 65 IssueID1 75–85 Occurrence Handle1:CAS:528:DC%2BD3sXlt1SqtA%3D%3D Occurrence Handle12554818
L Redwine RL Hauger JC Gillin M. Irwin (2000) ArticleTitleEffects of sleep and sleep deprivation on interleukin-6, growth hormone, cortisol, and melatonin levels in humans J Clin Endocrinol Metab. 85 IssueID10 3597–3603 Occurrence Handle1:CAS:528:DC%2BD3cXnsFOgt74%3D Occurrence Handle11061508
T Pollmacher J Mullington C Korth D. Hinze-Selch (1995) ArticleTitleInfluence of host defense activation on sleep in humans Adv Neuroimmunol. 5 IssueID2 155–169 Occurrence Handle1:STN:280:BymD2czovVY%3D Occurrence Handle7496610
DG Cruess MH Antoni J Gonzalez et al. (2003) ArticleTitleSleep disturbance mediates the association between psychological distress and immune status among HIV-positive men and women on combination antiretroviral therapy J Psychosom Res. 54 IssueID3 185–189 Occurrence Handle12614827
DF Darko MM Mitler JC. Miller (1998) ArticleTitleGrowth hormone, fatigue, poor sleep, and disability in HIV infection Neuroendocrinology. 67 IssueID5 317–324 Occurrence Handle1:CAS:528:DyaK1cXjsFans78%3D Occurrence Handle9641613
DF Darko JC Miller C Gallen et al. (1995) ArticleTitleSleep electroencephalogram delta-frequency amplitude, night plasma levels of tumor necrosis factor alpha, and human immunodeficiency virus infection Proc Natl Acad Sci USA. 92 IssueID26 12080–12084 Occurrence Handle1:CAS:528:DyaK28Xhtl2jsQ%3D%3D Occurrence Handle8618848
DF Darko MM Mitler SJ. Henriksen (1995) ArticleTitleLentiviral infection, immune response peptides and sleep Adv Neuroimmunol. 5 IssueID1 57–77 Occurrence Handle1:STN:280:ByqA3MnislQ%3D Occurrence Handle7795894
JA Cook MH Cohen J Burke etal. (2002) ArticleTitleEffects of depressive symptoms and mental health quality of life on use of highly active antiretroviral therapy among HIV-seropositive women J Acquir Immune Defic Syndr. 30 IssueID4 401–409 Occurrence Handle12138346
F Starace A Ammassari MP Trotta etal. (2002) ArticleTitleDepression is a risk factor for suboptimal adherence to highly active antiretroviral therapy J Acquir Immune Defic Syndr. 31 IssueID(Suppl 3 S136–S139 Occurrence Handle12562037
SM. Valente (2003) ArticleTitleDepression and HIV disease J Assoc Nurses AIDS Care. 14 IssueID2 41–51
SM Valente JM. Saunders (1997) ArticleTitleManaging depression among people with HIV disease J Assoc Nurses AIDS Care. 8 IssueID1 51–67 Occurrence Handle1:STN:280:ByiB3sblvVM%3D Occurrence Handle9085249
SM Valente JM Saunders G. Uman (1993) ArticleTitleSelf-care, psychological distress, and HIV disease J Assoc Nurses AIDS Care 4 IssueID4 15–25 Occurrence Handle1:STN:280:ByuC2snms1E%3D Occurrence Handle8130366
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Phillips, K.D., Sowell, R.L., Boyd, M. et al. Sleep quality and health-related quality of life in HIV-infected African-American women of childbearing age. Qual Life Res 14, 959–970 (2005). https://doi.org/10.1007/s11136-004-2574-0
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DOI: https://doi.org/10.1007/s11136-004-2574-0