Associations between widespread pain and sleep quality in people with HIV

Caroline A Sabin; Richard Harding; Nicki Doyle; Susan Redline; Davide DE Francesco; Patrick Wg Mallon; Frank A Post; Marta Boffito; Memory Sachikonye; Adam Geressu; Alan Winston; Ken M Kunisaki

doi:10.1097/QAI.0000000000002410

Associations between widespread pain and sleep quality in people with HIV

Caroline A Sabin, Richard Harding, Nicki Doyle, Susan Redline, Davide DE Francesco, Patrick Wg Mallon, Frank A Post, Marta Boffito, Memory Sachikonye, Adam Geressu, Alan Winston, Ken M Kunisaki

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood-Borne and Sexually Transmitted Infections at UCL in partnership with Public Health England (PHE).
Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, Cicely Saunders Institute, Kings College London, London, UK.
Department of Infectious Disease Epidemiology, Imperial College London School of Public Health, London, UK; Biomedical Research and Training Institute, Harare, Zimbabwe.
Harvard Medical School, Departments of Medicine and Neurology, Brigham and Women's Hospital, and Department of Medicine, Beth Israel Deaconess Medical Center.
UCL University College London
HIV Molecular Research Group, School of Medicine, University College Dublin, Ireland.
KCH King's College Hospital NHS Foundation Trust
Chelsea & Westminster Hospital NHS Foundation Trust
UK Community Advisory Board (UK-CAB), London, UK.
Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK.
Minneapolis Veterans Affairs Health Care System, and University of Minnesota, Minneapolis/USA.

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

BACKGROUND: We investigate the association of widespread pain with sleep quality among people with HIV and HIV-negative controls. SETTING: UK-based cohort. METHODS: Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in ≥4 of 5 body regions and in ≥7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later through 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal-Wallis tests, and linear/logistic regression considered associations between pain extent and sleep quality. RESULTS: Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Although there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7-16), 55.3 (48.0-58.9), and 57.2 (48.9-61.3), respectively, for those with widespread pain, 8 (4-13), 51.2 (45.5-58.3), and 50.3 (43.6-56.1) for those with regional pain, and 5 (2-9), 47.9 (42.9-54.3), and 45.5 (41.4-50.3) for those with no pain (all P values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms. CONCLUSIONS: Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in people with HIV.

Original language	English
Pages (from-to)	106-112
Number of pages	7
Journal	JAIDS
Volume	85
Issue number	1
Early online date	21 May 2020
DOIs	https://doi.org/10.1097/QAI.0000000000002410
Publication status	Published - 1 Sept 2020

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title = "Associations between widespread pain and sleep quality in people with HIV",

abstract = "BACKGROUND: We investigate the association of widespread pain with sleep quality among people with HIV and HIV-negative controls. SETTING: UK-based cohort. METHODS: Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in ≥4 of 5 body regions and in ≥7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later through 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal-Wallis tests, and linear/logistic regression considered associations between pain extent and sleep quality. RESULTS: Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Although there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7-16), 55.3 (48.0-58.9), and 57.2 (48.9-61.3), respectively, for those with widespread pain, 8 (4-13), 51.2 (45.5-58.3), and 50.3 (43.6-56.1) for those with regional pain, and 5 (2-9), 47.9 (42.9-54.3), and 45.5 (41.4-50.3) for those with no pain (all P values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms. CONCLUSIONS: Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in people with HIV.",

author = "Sabin, {Caroline A} and Richard Harding and Nicki Doyle and Susan Redline and Francesco, {Davide DE} and Mallon, {Patrick Wg} and Post, {Frank A} and Marta Boffito and Memory Sachikonye and Adam Geressu and Alan Winston and Kunisaki, {Ken M}",

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doi = "10.1097/QAI.0000000000002410",

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T1 - Associations between widespread pain and sleep quality in people with HIV

AU - Sabin, Caroline A

AU - Harding, Richard

AU - Doyle, Nicki

AU - Redline, Susan

AU - Francesco, Davide DE

AU - Mallon, Patrick Wg

AU - Post, Frank A

AU - Boffito, Marta

AU - Sachikonye, Memory

AU - Geressu, Adam

AU - Winston, Alan

AU - Kunisaki, Ken M

PY - 2020/9/1

Y1 - 2020/9/1

N2 - BACKGROUND: We investigate the association of widespread pain with sleep quality among people with HIV and HIV-negative controls. SETTING: UK-based cohort. METHODS: Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in ≥4 of 5 body regions and in ≥7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later through 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal-Wallis tests, and linear/logistic regression considered associations between pain extent and sleep quality. RESULTS: Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Although there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7-16), 55.3 (48.0-58.9), and 57.2 (48.9-61.3), respectively, for those with widespread pain, 8 (4-13), 51.2 (45.5-58.3), and 50.3 (43.6-56.1) for those with regional pain, and 5 (2-9), 47.9 (42.9-54.3), and 45.5 (41.4-50.3) for those with no pain (all P values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms. CONCLUSIONS: Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in people with HIV.

AB - BACKGROUND: We investigate the association of widespread pain with sleep quality among people with HIV and HIV-negative controls. SETTING: UK-based cohort. METHODS: Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in ≥4 of 5 body regions and in ≥7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later through 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal-Wallis tests, and linear/logistic regression considered associations between pain extent and sleep quality. RESULTS: Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Although there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7-16), 55.3 (48.0-58.9), and 57.2 (48.9-61.3), respectively, for those with widespread pain, 8 (4-13), 51.2 (45.5-58.3), and 50.3 (43.6-56.1) for those with regional pain, and 5 (2-9), 47.9 (42.9-54.3), and 45.5 (41.4-50.3) for those with no pain (all P values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms. CONCLUSIONS: Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in people with HIV.

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U2 - 10.1097/QAI.0000000000002410

DO - 10.1097/QAI.0000000000002410

M3 - Article

C2 - 32452971

SN - 1525-4135

VL - 85

SP - 106

EP - 112

JO - JAIDS

JF - JAIDS

IS - 1

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Associations between widespread pain and sleep quality in people with HIV

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