Sleep quality following antiretroviral therapy initiation and during long-term suppressive treatment in adults with HIV: A pilot study

Objective Sleep problems are common among people with HIV, but prospective data on sleep quality early after antiretroviral therapy (ART) initiation are limited. This pilot study evaluated changes in sleep quality during the first month after ART initiation. Methods In this pilot cohort study, sleep quality was prospectively assessed using the Pittsburgh Sleep Quality Index (PSQI) at ART initiation and 1 month later in an ART-initiation. A separate group receiving virologically suppressive ART for at least 1 year was assessed cross-sectionally. Continuous variables are presented as median [interquartile range (IQR)]. Results Nine participants were included in the ART-initiation group and 39 in the long-term suppressive ART group. In the ART-initiation group, median global PSQI scores were 4 [IQR 3–7] at baseline and 4 [IQR 4–6] at month 1, with no significant change ( p = 0.915). Poor sleep quality (PSQI >5) was present in 33% at both assessments. In the long-term suppressive ART group, the median PSQI score was 6 [IQR 4–8], and 51% had poor sleep quality. Neither PSQI scores ( p = 0.247) nor the prevalence of poor sleep quality ( p = 0.466) differed significantly between baseline and the long-term suppressive ART group. Conclusion No detectable change in sleep quality was observed during the first month after ART initiation. Approximately half of participants receiving long-term suppressive ART had poor sleep quality. These findings suggest that sleep quality may be a clinically relevant patient-reported outcome to consider during routine HIV care.