Evaluating sleep and cognition in HIV

Charlene E. Gamaldo, Alyssa Gamaldo, Jason Creighton, Rachel E. Salas, Ola A Selnes, Paula M. David, Gilbert Mbeo, Benjamin S. Parker, Amanda Brown, Justin C. McArthur, Michael T. Smith

Research output: Contribution to journalArticlepeer-review


Objective: To examine the relationship between measures of sleep quality and cognitive performance in HIV-positive individuals stable on combination antiretroviral therapy. Design: Multimethod assessments of sleep quality, patterns, and cognitive performance were assessed in a predominantly black HIVpositive cohort. Methods: Sleep quality and patterns were characterized in 36 subjects by polysomnogram, 2-week actigraphy monitoring, and validated sleep questionnaires. Cognitive performance was assessed with a battery of neuropsychological tests. Results: The majority of participants were cognitively impaired [based on Frascati (75%) criteria]. Self-reported mean scores on the Pittsburgh sleep quality index and the insomnia severity scale suggested poor sleep quality. Better cognitive performance, particularly on tasks of attention, frontal/executive function, and psychomotor/ motor speed, was associated with polysomnogram sleep indices (ie, reduced wake after sleep onset, greater sleep efficiency, greater sleep latency, and greater total sleep time). Thirty-seven percent of participants had sleep patterns suggestive of chronic partial sleep deprivation, which was associated with significantly worse performance on the digit symbol test (P = 0.006), nondominant pegboard (P = 0.043), and verbal fluency tests (P = 0.044). Conclusions: Our results suggest that compromised sleep quality and duration may have a significant impact on cognitive performance in HIV-positive individuals. Future studies are warranted to determine the utility of sleep quality and quantity indices as potential predictive biomarkers for development and progression of future HIV-associated neurocognitive disorder.

Original languageEnglish (US)
Pages (from-to)609-616
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number5
StatePublished - Aug 15 2013


  • Cognition
  • HIV
  • Quality of life
  • Sleep
  • Sleep disorders

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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