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

46 Scopus citations


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

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)


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