Friday, July 11, 2003

This presentation is part of : Living with HIV

Circadian Rhythms in HIV

Donna H Taliaferro, RN, PhD, Adult Health, Virginia Commonwealth University, Richmond, VA, USA, Holly Dileo, RN, FNP, doctoral student, Family Nursing Care, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA, and Chantelle Wyglendowski, RN, BSN, Family Nursing, Virginia Commonwealth University, Richmond, VA, USA.
Learning Objective #1: Identify sleep disturbances with HIV infected individuals
Learning Objective #2: Explore circadian rhythm analysis using actigraphy

OBJECTIVE: Caring for persons with HIV/AIDS presents challenges in both physical and emotional care. Sleep disturbances in HIV infected persons are the third cause for seeking medical help even with the new advances in HAART therapy. Therefore, the broad purpose of the study was to compare the patient’s subjective experience of sleep with the objective measure of a computerized measurement device and hormone production. DESIGN: A descriptive, repeated measures design was used. Observations were made over four days (24 hour periods). Time series analyses were used to determine serial correlations of periods and phases of circadian rhythms. POPULATION, SAMPLE, SETTING, YEARS: HIV subjects were studied from an inpatient AIDS facility in Southwest Texas over a three-year period. Both male and female subjects were studied (n=45). OUTCOME VARIABLES: The primary attribute variable was HIV seropositive status. Outcome variables were core body temperature, activity, sleep efficiency, sleep latency and subjective sleep. Melatonin and cortisol levels were measured to determine production rates and times of peaks and troughs. METHODS: The Sleep Disturbance Scale (Kathy Lee, UCSF) was used and the subjects wore the Actiwatch (Mini-Mitter, Sunriver, OR) for 48 consecutive hours. In the second 48 hours salivary melatonin, cortisol, and core temperature data were collected. FINDINGS: Sleep efficiency negatively correlated with sleep disturbance (a= -.85). Sleep efficiency scores ranged from 36% to 81%. Sleep latency periods ranged from 17 minutes to 4 hours. Temperature data continued to support previous research with the hectic nature of the temperature and a higher set point. CONCULSION: Subjects indicate sleep problems and is supported by sleep efficiency scores. The lack of temperature decline in the early evening has direct effects on the circadian function. IMPLICATIONS: Sleep has profound effects on both the quality of life and functional status. Activities of daily living are impaired. FUNDING: NIH/NINR #1R15NRO4873-01

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