Fatores associados aos distúrbios do sono em pessoas vivendo com HIV

Abstract

Sleep disorders among People Living with HIV (PLHIV) seem to have multiple causes, which may vary according to the sociodemographic, clinical and cultural characteristics of each re gion. The main objective of the study was to identify the factors associated with sleep disor ders in PLHIV. This is a cross-sectional study carried out at the infectology outpatient clinic of Hospital São José (HSJ) in Fortaleza, Ceará. The calculated sample consisted of 385 PLHIV, selected by non-probabilistic convenience sampling, who were invited to participate in the study while waiting for a medical appointment. Inclusion criteria: PLHIV of both sexes, age 18 years or older, on antiretroviral therapy (ART) for at least three months. Exclusion criteria: pregnant women, disabling mental illness, homeless and deprived of liberty. Data collection took place over the period from 2020 to 2021, through an interview, with an aver age duration of 40 minutes, using the instruments: 1. Sociodemographic, Clinical and Epide miological Form for PLHIV; 2. Pittsburgh Sleep Quality Index (PSIQ-BR); 3. Beck Depres sion Inventory (BDI), 4. Beck Anxiety Inventory (BAI); 5. Questionnaire for Assessment of Adherence to Antiretroviral Treatment (CEAT-HIV). In the data analysis, descriptive statis tics, univariate and multivariate logistic regression analysis were performed to determine the adjusted odds ratio (OR), precision (95% confidence interval - 95% CI) and significance of the estimate (Wald test). Two-tailed tests were used, establishing the level of significance at 0.05 (5%), considering the value P<0.05 as statistically significant. IBM SPSS Statistics soft ware version 23.0 was used for statistical procedures. The project was approved by the Re search Ethics Committees of the Federal University of Ceará and HSJ, in accordance with Resolution No. 466/2012. The results showed that the prevalence of sleep disorders was 43.38% (95% CI: 38.43% - 48.33%). In the multivariate analysis, only the fact of having chil dren (OR=1.91; P=0.0054), having eight years of schooling or less (OR=2.11; P=0.0013) and not practicing regular physical exercise (OR=2.61; P=0.0001), were independent factors asso ciated with the occurrence of sleep disorders in PLHIV. As for the explanatory variable anxie ty, it was found in the multivariate analysis that being female (OR=1.95; P=0.0227) and hav ing depression (OR=12.26; P<0.0001) were factors associated with anxiety in PLHIV. There was no statistically significant association between anxiety and sleep disorders. In the multi variate logistic regression analysis for the explanatory variable depression, it was found that being retired (OR=2.67; P=0.0204), on leave/sick leave (OR=3.90; P=0.0005 ), with detecta ble viral load (OR=1.79; P=0.0476), without regular physical exercise (OR=2.37; P=0.0070), having sleep disorders (OR=3.08; P =0.0001) and anxiety (OR=12.67; P<0.0001) were inde pendent factors associated with depression. For adherence to ART, in the multivariate analy sis, only detectable viral load (OR=6.69; P=0.0001) was a factor associated with inadequate adherence. There was no statistical association between adherence to ART and sleep disor ders. It was concluded that 43.38% of PLHIV in the sample had sleep disorders, especially those with children, eight years of schooling or less and who did not practice regular physical exercise. Just the depression was associated with the occurrence of sleep disorders in PLHIV. The study showed important data for the development of health interventions by nursing and other members of the multidisciplinary team for PLHIV.