0749 A Social Ecological Perspective on Sleep Hygiene Habits in Older Adults with HIV

Abstract Introduction Nearly 75% of people with HIV (PWH) report poor sleep quality, a risk factor for impairment in daily activities, poorer quality of life, and declines in physical and mental health. However, little is known about the multifactorial causes of poor sleep, rendering it difficult to treat. We examined sleep hygiene habits in PWH through qualitative and quantitative methods. Methods Using qualitative analyses, we examined sleep hygiene habits in older virally suppressed PWH on antiretroviral therapy who enrolled from December 2021 to September 2022 in this cross-sectional study. Individuals participated in semi-structured telephone interviews regarding sleep hygiene habits. Interviews were recorded, transcribed verbatim, and coded by three independent coders, codes were adjudicated and analyzed for common themes using Dedoose 9.0.82 software. The Social Ecological Model constructed with five levels: individual, interpersonal, organization, community, and policy served as the framework. Self-reported sleep quality data was measured with the Pittsburgh Sleep Quality Index (PSQI). Results Among 50 PWH, the mean age was 54 years, 32% were female (n=16), and 62% identified as African American/Black (n=31). The mean PSQI was 9 (median: 9, interquartile range: 5-14). The individual level themes identified were: 1) Shorter Sleep Duration and the Ripple Effect; 2) Poor Bedtime Habits; 3) The Sleep and Physical Activity Connection; and 4) Late Night Bites. The interpersonal level themes identified were: 1) Family Ties: The Impact of Family on Sleep; 2) Balancing Act: The Interplay between Work and Sleep; and 3) The Impact of Aging and Stimuli on Sleep. The theme at the organizational level identified was Sleep Health Neglect, that refers to a lack of adherence and continuity of sleep health care. Conclusion Poor sleep habits including lack of physical activity and late-night eating, family, work, aging, internal and external stimuli compete with the opportunity to sleep and contribute to inadequate amounts of sleep and/or poor quality sleep. Moreover, the lack of adherence and continuity of sleep health care also negatively impacts the perceived sleep quality of aging PWH. Future studies should consider a multimodal intervention approach to mitigating poor sleep quality in this population. Support (if any) National Institutes of Nursing Research grants: K23NR019744 and R01NR018391.