This study examined the relationships among subjective sleep disturbance, depressive symptoms, and adherence to medications among HIV-infected women. HIV-infected women ( N = 173) were recruited through community AIDS service organizations throughout South Carolina. Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Centers for Epidemiological Studies Depression Scale (CES-D), and a modified version of the Adults AIDS Clinical Trials Group Adherence Baseline Questionnaire. Women who reported greater sleep disturbance also reported a higher level of depressive symptoms and reported poor adherence to their medication regimen. Depression helped to explain the relationship between sleep quality and adherence. Results indicate that assessment and management of sleep disturbance and depressive symptoms in women with HIV disease is important to promote medication adherence.
Adrien, J. (2002). Neurobiological bases for the relation between sleep and depression. Sleep Medicine Review, 6, 341-351.
2.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
3.
Benca, R. M., Obermeyer, W. H., Thisted, R. A., & Gillin, J. C. (1992). Sleep and psychiatric disorders. A meta-analysis. Archives of General Psychiatry, 49, 651-668.
4.
Cheeta, S., Ruigt, G., van Proosdij, J., & Willner, P. (1997). Changes in sleep architecture following chronic mild stress. Biological Psychiatry, 41, 419-427.
5.
Chesney, M. A., & Folkman, S. (1994). Psychological impact of HIV disease and implications for intervention. Psychiatric Clinics of North America, 17, 163-182.
6.
Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, A. L., Neidig, J., Zwickl, B., et al. (2000). Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care, 12, 255-266.
7.
Cruess, D. G., Antoni, M. H., Gonzalez, J., Fletcher, M. A., Klimas, N., Duran, R., et al. (2003). Sleep disturbance mediates the association between psychological distress and immune status among HIV-positive men and women on combination antiretroviral therapy. Journal of Psychosomatic Research, 54, 185-189.
8.
Cruess, D. G., Evans, D. L., Repetto, M. J., Gettes, D., Douglas, S. D., & Petitto, J. M. (2003). Prevalence, diagnosis, and pharmacological treatment of mood disorders in HIV disease. Biological Psychiatry, 54, 307-316.
9.
De Jose, M. I., Ramos, J. T., Alvarez, S., Jimenez, J. L., & Munoz-Fernandez, M. A. (2001). Vertical transmission of HIV-1 variants resistant to reverse transcriptase and protease inhibitors. Archives of Internal Medicine, 161, 2738-2739.
10.
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101-2107.
11.
Dinges, D. F., Douglas, S. D., Hamarman, S., Zaugg, L., & Kapoor, S. (1995). Sleep deprivation and human immune function. Advances in Neuroimmunology, 5, 97-110.
12.
Fleishman, J. A., & Hellinger, F. H. (2003). Recent trends in HIV-related inpatient admissions 1996-2000: A 7-state study. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 34, 102-110.
13.
Gifford, A. L., Bormann, J. E., Shively, M. J., Wright, B. C., Richman, D. D., & Bozzette, S. A. (2000). Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 23, 386-395.
14.
Gill, C. J., Griffith, J. L., Jacobson, D., Skinner, S., Gorbach, S. L., & Wilson, I. B. (2002). Relationship of HIV viral loads, CD4 counts, and HAART use to health-related quality of life. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 30, 485-492.
15.
Hand, G. A., Phillips, K. D., Sowell, R. L., Rojas, M., & Becker, J. (2003). Prevalence of poor sleep quality in a HIV+ population of African Americans. Journal of the South Carolina Medical Association, 99, 183-187.
16.
Ickovics, J. R., Hamburger, M. E., Vlahov, D., Schoenbaum, E. E., Schuman, P., Boland, R. J., et al. (2001). Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: Longitudinal analysis from the HIV Epidemiology Research Study. Journal of the American Medical Association, 285, 1466-1474.
17.
Irwin, M. (2002). Effects of sleep and sleep loss on immunity and cytokines. Brain, Behavior, and Immunity, 16, 503-512.
18.
Knobel, H., Guelar, A., Carmona, A., Espona, M., Gonzalez, A., Lopez-Colomes, J. L., et al. (2001). Virologic outcome and predictors of virologic failureof highly active antiretroviral therapy containing protease inhibitors. AIDS Patient Care and STDs, 15, 193-199.
19.
Leserman, J. (2003). HIV disease progression: Depression, stress, and possible mechanisms. Biological Psychiatry, 54, 295-306.
20.
Liu, H., Golin, C. E., Miller, L. G., Hays, R. D., Beck, C. K., Sanandaji, S., et al. (2001). A comparison study of multiple measures of adherence to HIV protease inhibitors. Annals of Internal Medicine, 134, 968-977.
21.
Low-Beer, S., Yip, B., O’Shaughnessy, M. V., Hogg, R. S., & Montaner, J. S. (2000). Adherence to triple therapy and viral load response. Journal of Acquired Immune Deficiency Syndromes, 23, 360-361.
22.
Melbourne, K. M., Geletko, S. M., Brown, S. L., Willey-Lessne, C., Chase, S., & Fisher, A. (1999). Medication adherence in patients with HIV infection: A comparison of two measurement methods. AIDS Reader, 9, 329-338.
23.
Miller, L. G., & Hays, R. D. (2000). Measuring adherence to antiretroviral medications in clinical trials. HIV Clinical Trials, 1, 36-46.
24.
Montaner, J. S., Reiss, P., Cooper, D., Vella, S., Harris, M., Conway, B., et al. (1998). A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: The INCAS Trial. Italy, The Netherlands, Canada and Australia Study. Journal of the American Medical Association, 279, 930-937.
25.
Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., et al. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133, 21-30.
26.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in general population. Applied Psychological Measurements, 1, 385-401.
27.
Richman, D., Bozzette, S., Morton, S., Chien, S., Wrin, T., Dawson, K., et al. (2001, December 18). The prevalence of antiretroviral drug resistance in the United States. Program and abstracts of the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) (Abstract LB-17), Chicago.
28.
Riemann, D., Berger, M., & Voderholzer, U. (2001). Sleep and depression—results from psychobiological studies: An overview. Biological Psychology, 57, 67-103.
29.
Rousseau, M. N., Vergne, L., Montes, B., Peeters, M., Reynes, J., Delaporte, E., et al. (2001). Patterns of resistance mutations to antiretroviral drugs in extensively treated HIV-1-infected patients with failure of highly active antiretroviral therapy. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 26, 36-43.
30.
Rubinstein, M. L., & Selwyn, P. A. (1998). High prevalence of insomnia in an outpatient population with HIV infection. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 19, 260-265.
31.
Salomon, H., Wainberg, M. A., Brenner, B., Quan, Y., Rouleau, D., Cote, P., et al. (2000). Prevalence of HIV-1 resistant to antiretroviral drugs in 81 individuals newly infected by sexual contact or injecting drug use. Investigators of the Quebec Primary Infection Study. AIDS, 14, F17-F23.
32.
Sankar, A., Luborsky, M., Schuman, P., & Roberts, G. (2002). Adherence discourse among African-American women taking HAART. AIDS Care, 14, 203-218.
33.
Seifritz, E. (2001). Contribution of sleep physiology to depressive pathophysiology. Neuropsychopharmacology, 25, S85-S88.
34.
Selik, R. M., & Lindegren, M. L. (2003). Changes in deaths reported with human immunodeficiency virus infection among United States children less than thirteen years old, 1987 through 1999. Pediatric Infectious Diseases Journal, 22, 635-641.
35.
Shaffery, J. P., Hoffman, R., & Armitage, R. (2003). The neurobiology of depression: Perspectives from animal and human sleep studies. The Neuroscientists, 9, 82-98.
36.
Shaffery, J. P., Sinton, C. M., Bissette, G., Roffwarg, H. P., & Marks, G. A. (2002). Rapid eye movement sleep deprivation modifies expression of long-term potentiation in visual cortex of immature rats. Neuroscience, 110, 431-443.
37.
Starace, F., Ammassari, A., Trotta, M. P., Murri, R., De Longis, P., Izzo, C., et al. (2002). Depression is a risk factor for suboptimal adherence to highly active antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 31(Suppl. 3), S136-S139.
38.
Thase, M. E. (1999). Antidepressant treatment of the depressed patient with insomnia. Journal of Clinical Psychiatry, 60(Suppl. 17), 28-31.
39.
Wing, R. R., Phelan, S., & Tate, D. (2002). The role of adherence in mediating the relationship between depression and health outcomes. Journal of Psychosomatic Research, 53, 877-881.
