Poor subjective sleep reported by people living with HIV is associated with impaired working memory

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Background. Poor sleep can undermine the health of people in general and may be especially disruptive to those with chronic conditions including HIV infection. Methods. Here, clinically well-described people living with HIV infection [PLWH] (74 men, 35 women) and healthy control (38 men, 35 women) participants were administered the Pittsburgh Sleep Quality Index (PSQI), which is a validated measure of subjective sleep with a global score ≥ 5 able to distinguish good from poor sleepers. In addition, participants completed neuropsychological tests assessing executive functioning, working memory, and learning and memory. Results. PLWH (6.8±3.7) had higher global PSQI scores than those of healthy controls (4.1±2.8): 39.7% of uninfected controls and 68.8% of PLWH had a PSQI ≥ 5 indicative of poor sleep. There were no relations between the global PSQI score and any evaluated variables among healthy-control individuals or with demographic or HIV-related variables in PLWH. Instead, a higher global PSQI score among PLWH was associated with worse “Quality of Life” measures including scores on the Global Assessment of Functioning (GAF, p = .0007), the Medical Outcomes Study survey (21-item short form, SF-21, p < .0001), and Activities of Daily Living-Instrumental (ADL-I, p = .0041); and more depressive symptoms as determined by the Beck Depression Index (BDI, p < .0001). Further, in PLWH, a higher global PSQI score was associated with poor performance on a working memory task, the digit backward span (p = .0036). In PLWH, the 5 variables together explained 32.3% of the global PSQI score variance; only 3 variables – the SF-21, BDI, and digit backward scores – explained 30.6% of the variance. Conclusions. To the extent that poor subjective sleep contributes to impaired working memory in HIV, we speculate that this impairment may be ameliorated by improved sleep health.