Quality of Sleep and Risk of Obstructive Sleep Apnea in Adults With Hiv Infection at Kenyatta National Hospital

Abstract

Background: Sleep disorders and poor sleep quality are more prevalent among HIV patients, with rates ranging from 30 percent to 100 percent, compared to 13 percent to 30 percent universally. In Kenya, there is a scarcity of data on sleep disorders, both in the general population and among people living with HIV (PLHIV). The main purpose of this study was to determine the quality of sleep and risk of obstructive sleep apnea in adult HIV infected patients attending the Kenyatta National Hospital's HIV Clinic. Methodology: This was a cross-sectional study conducted in a hospital setting. The study site was the KNH HIV Clinic. HIV-positive adults aged 18 and above made up the study population. Participants who met the eligibility criteria and provided written informed consent were recruited into the study. The Pittsburgh Sleep Quality Index (PSQI), the STOP-BANG Questionnaire (SBQ), the Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire- 9 (PHQ-9) were used to measure sleep quality, risk of obstructive sleep apnea (OSA), anxiety, and depression, respectively. Data was entered and managed in epidata version 3.1 and then exported to SPSS version 26.0 statistical software for analysis. Quality of sleep and risk for OSA were calculated and presented as percentages with 95% confidence interval. Chi-square or Fischer’s exact test were conducted to determine bivariable associations. Logistic regression was used in multivariate analysis. All statistical tests were performed at a significance level of 5%. Results: 312 participants were recruited into the study. 59.6% of the respondents had poor sleep quality while 58.7% of the respondents had high risk of obstructive sleep apnea. 43.3% of patients had anxiety while 31.4% had depression. On multivariate analysis, having a comorbidity, anxiety, or depression, was independently associated with poor sleep quality. Male gender, increase in age, body mass index and neck circumference were independently associated with high risk of OSA. Conclusion: Poor quality of sleep is quite common among people living with HIV. Risk for obstructive sleep apnea is also high in this patient cohort. Early recognition and treatment of sleep disturbances could aid in overall improvement of health and quality of life.