Sleep is a natural process that the brain requires to keep proper functioning and maintain the health of the human body. Sleep occupies one third of human life and its deprivation causes negative consequences that may be physical, cognitive, or emotional. Suffering from inadequate sleep has been associated with chronic medical illness like diabetes, stroke, heart disease and Human immunodeficiency virus or Acquired immune deficiency syndrome (HIV/AIDS) [1, 2].
HIV/AIDS is a chronic, potentially life threatening condition caused by the HIV, which affects mostly the immune system and nervous system. It’s among the most overwhelming health problems throughout the world and especially in developing countries . It is estimated that 36.7 million people are living with HIV/AIDS in the world. In Ethiopia, the national adult HIV/AIDS prevalence has been reported to be 1.14%. It has been estimated that 542,121 adults and 178,500 children require antiretroviral treatment in Ethiopia . Sleep disturbance is one of the most prevalent symptoms in individuals infected with HIV/AIDS where 40% to 70% of individuals infected with HIV/AIDS are reporting significant sleep disturbances, including difficulty falling asleep, awakenings during the night, and reduced sleep time [5-7].
Sleep disturbance among people living with HIV/AIDS occurs throughout the stages of the infection, but more prevalent in the advanced stage. Despite this fact, still it receives little attention. This may be, because it is considered as a normal consequence of the disease and its treatment, or considered to be insignificant in comparison with other complications of HIV infection .
But sleep deprivation among people living with HIV/AIDS leads to various effects, such as impaired immune system, hampered physical performance, affected cell growth and repair, deteriorated neuronal connections and neuronal malfunctions . In addition, it may also increase the risk of cardiovascular morbidity and mortality, and the degree of suffering with psychiatric disorders .
According to study results, sleep disturbance is not only prevalent, but also there are more intense and distressful symptoms experienced by the HIV population. As a result, such individuals are less likely to adhere to their antiretroviral therapy regimens probably as a result of depression [6, 12-14].
A cross-sectional surveys conducted in China and France showed that prevalence of sleep disturbances and Poor sleep quality was 43.1% and 47% respectively. Prevalence of sleep disturbances differed significantly between those who suffered anxiety and depression and those who did not. Moreover, being male, a smoker, living single, being unemployed or moderately or seriously depressed were significantly associated with poor sleep quality [15, 16].
According to a survey conducted in Latin America countries Mexico and South East Brazil 58.6% and 46.7% had poor sleep quality respectively. Depressive symptoms, illicit drug use, a CD4 count < 200 cells/μl, and longer duration of HIV/AIDS diagnosis was positively associated with poor sleep quality[17, 18].
Similarly, studies conducted in Nigeria among HIV-positive outpatients reported that 46.2% in University of Calabar Teaching Hospital and 59.3% in Lagos State University Teaching Hospital had sleep disorders and poor sleep quality respectively. Elevated systolic blood pressure, shorter duration of HIV diagnosis and HAART type were associated with sleep disorders and poor sleep quality [19, 20].
Despite this significant health problems and higher prevalence, sleep quality among people with HIV/AIDS remains under-studied with no published study in Ethiopia. Therefore, the aim of this study was to assess the magnitude of sleep quality and it’s among people living with HIV/AIDS in Zewditu Memorial Hospital, Ethiopia.