Juan A Esquivel-Mendoza, Satyanand Satyanarayana, Steven Safren, Brooke G Rogers
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引用次数: 0
Abstract
Objective: The management of HIV has shifted from a focus solely on the disease to a broader perspective encompassing co-occurring medical conditions and quality of life. Mental health concerns such as depression and sleep disturbances, particularly insomnia, are often overlooked in HIV care. The aim of the study was to investigate the longitudinal impact of insomnia on depression and medication adherence among (PLWH).
Methods: This study, conducted in an urban HIV clinic, involved active patients and assessed depression, insomnia, and medication adherence at baseline, 3-month, and 6-month intervals. Hierarchical linear models were employed to analyze the fixed and random effects of time, within-person and between-person insomnia on depression, as well as the effects of time, within-person and between-person depression on ART adherence.
Results: Within-person effects revealed that each one unit increase in the Insomnia Severity Index (ISI) was associated with a b = 0.267-point rise in Patient Health Questionnaire-9 (PHQ-9) scores (p < .001). Between-person effects revealed that each one-point increase in an individual's average ISI score was associated with a 0.476-point elevation in their PHQ-9 scores (p < .001). The between-person effects of depression on medication adherence indicated significance, with each point increase in an individual's average PHQ-9 score being linked to a 0.36% decrease in adherence (p = .012).
Conclusion: The study underscores the potential impact of insomnia on mental health and treatment adherence in people living with HIV (PLWH). This study emphasizes the necessity of comprehensive care models considering the interplay between sleep quality, mental health, and medication adherence for PLWH.
目的：艾滋病的治疗已从单纯关注疾病转变为更广泛的视角，包括并发症和生活质量。抑郁和睡眠障碍（尤其是失眠）等心理健康问题往往在艾滋病护理中被忽视。本研究旨在调查失眠对抑郁症和 PLWH 服药依从性的纵向影响：本研究在城市的一家艾滋病诊所进行，涉及活跃的患者，并在基线、3 个月和 6 个月的时间间隔内对抑郁、失眠和服药依从性进行评估。采用层次线性模型分析了时间、人内失眠和人际失眠对抑郁的固定和随机影响，以及时间、人内抑郁和人际抑郁对坚持抗逆转录病毒疗法的影响：人内效应显示，失眠严重程度指数（ISI）每增加一个单位，患者健康问卷-9（PHQ-9）得分就会增加 b = 0.267 分（p p p = .012）：本研究强调了失眠对艾滋病毒感染者（PLWH）心理健康和坚持治疗的潜在影响。这项研究强调了综合护理模式的必要性，它考虑到了睡眠质量、心理健康和艾滋病病毒感染者坚持服药之间的相互作用。
期刊介绍：
Behavioral Sleep Medicine addresses behavioral dimensions of normal and abnormal sleep mechanisms and the prevention, assessment, and treatment of sleep disorders and associated behavioral and emotional problems. Standards for interventions acceptable to this journal are guided by established principles of behavior change. Intending to serve as the intellectual home for the application of behavioral/cognitive science to the study of normal and disordered sleep, the journal paints a broad stroke across the behavioral sleep medicine landscape. Its content includes scholarly investigation of such areas as normal sleep experience, insomnia, the relation of daytime functioning to sleep, parasomnias, circadian rhythm disorders, treatment adherence, pediatrics, and geriatrics. Multidisciplinary approaches are particularly welcome. The journal’ domain encompasses human basic, applied, and clinical outcome research. Behavioral Sleep Medicine also embraces methodological diversity, spanning innovative case studies, quasi-experimentation, randomized trials, epidemiology, and critical reviews.
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