Poor sleep quality is linked to increased frailty in middle-aged people living with HIV in Botswana

TL;DR

Poor sleep quality is associated with increased frailty in middle-aged people living with HIV in Botswana.

Contribution

This study identifies a novel link between poor sleep and increased frailty specifically in HIV-positive individuals in Botswana.

Findings

PLWH have 2.88 times higher odds of poor sleep compared to HIV-negative controls.

Poor sleep is associated with a >1 standard deviation increase in frailty index among PLWH.

The association between poor sleep and frailty is not observed in HIV-negative controls.

Abstract

This work aims to evaluate associations between self-reported sleep health and frailty in Botswana, a sub-Saharan Africa setting. Fifty persons living with HIV (PLWH) on suppressive antiretroviral therapy (ART) and fifty HIV seronegative control participants are enrolled in Botswana. Sleep quality is scored subjectively as “good” or “poor” based on self-report. A frailty index (FI) is constructed based on thirty-three health deficits related to body mass index, waist circumference, physical activity, emotional status, and fatigue, and scored ranging between 0 (no deficit present) and 1 (all deficits present). Sleep quality between PLWH and controls is compared using logistic regression; linear regression is performed to compare the FI between them. Linear regressions are performed to examine the association between the FI and sleep quality stratified by HIV serostatus. Age, sex, and comorbidities are adjusted; when relevant, CD4 cell and ART duration are controlled. PLWH display 2.88 (95% CI: 1.22–6.79, p = 0.02) higher odds of having poor sleep than controls. Having poor sleep is associated with increased FI in PLWH but not in controls. Specifically, compared with PLWH who have good sleep, PLWH who report poor sleep have a > 1 standard deviation (p < 0.0001) increase in their FI score.