Qualidade do sono e sintomas de insônia em pessoas vivendo com HIV em tratamento com antirretrovirais

Abstract

Introduction: Infection with the human immunodeficiency virus (HIV) has developed characteristics of chronicity after the introduction of ART, and the undesirable effects not eliminated increase the suffering of people living with HIV (PLHIV) undergoing ART, with high financial investments and causing sleep disturbances and mental disorders that interfere with the immunological system. Objectives: To compare sleep quality and insomnia symptoms among PLHIV, according to the used ART schemes. Methods: Cross-sectional epidemiological study carried out with 322 PLHIV who were under clinical follow-up by the Specialized AIDS Care Service (SAE) of Santos / SP. Data were collected from February to June 2016. The study dependent variables were sleep quality and insomnia symptoms, obtained through individual interviews at the SAE. The independent variable was the ART regimen, obtained from medical records at the SAE pharmacy and classified based on information obtained from the package inserts forwarded by ANVISA related to possible adverse reactions on sleep: they cause insomnia and drowsiness, they cause only insomnia and they do not cause insomnia or drowsiness. Statistical analysis was performed on STATA 12.0 and STATISTICA 7.0, with a significance level of 5%. Results: The average age of the participants was 47.86 years (SD = 12.06), most were female (52.16%), woman gender (54.67%), single (50.17 %), with incomplete high school (50.50%), did not live with children (70.19%) and did not engage in paid activity (60.47%). Most said they did not smoke (70%), did not consume alcoholic beverages (96.35%) and did not use illicit drugs (68.77%). The average time of HIV diagnosis was 12.59 years (SD = 8.03), the average time of use of the current HAART scheme was 9.38 years (SD = 7.57). However, 50% of the sample has already changed the first ART scheme. The majority (73.6%) used an ART regimen that caused insomnia and drowsiness and 53.49% regularly used other medications in addition to ART. The morning chronotype was predominant (58.47%) among study participants. Regarding sleep quality, it was observed that most were classified as having poor sleep quality (55.15%) and had symptoms of insomnia (79.12%). In the generalized linear model adjusted for sex, age, time of HIV discovery and time of use of the current HAART regimen, it was found that there is no statistically significant difference in the average scores of sleep quality among those who use HAART regimen that do not interferes with sleep aspects (5.06 points), which causes insomnia (6.75 points) and which causes insomnia and drowsiness (5.67 points), nor the average number of insomnia symptoms (2.09, 2, 43 and 2.35 insomnia symptoms, respectively) Conclusion: The prevalence of poor sleep quality and insomnia symptoms is high among PLHIV, however there is no difference according to ART, which indicates that in general, both ART and factors related to immunity and the disease status itself are associated with sleep problems among PLHIV.