Increased Risk of Depression in Non-Depressed HIV Infected Men with Sleep Disturbance: Prospective Findings from the Multicenter AIDS Cohort Study

Michael Irwin, Gemma Archer, RIchard Olmstead, Todd T. Brown, Linda Teplin, Sanjay R. Patel, Alison G. Abraham, Elizabeth C. Breen
2018 Social Science Research Network  
Objective: Sleep disturbance is a known risk factor for depression, but it is not known whether sleep disturbance contributes to greater risk of depression in those infected with human immunodeficiency virus (HIV+) as compared to those uninfected with HIV (HIV-). Methods: Using data from the Multicenter AIDS Cohort Study, a population-based prospective study of men who have sex with men (MSM), self-reported sleep disturbance (N2 weeks) and depressive symptoms (Clinical Epidemiologic Scale for
more » ... iologic Scale for Depression, CES-D) were assessed every 6 months over 12 years of follow-up. Adjusted mixed effects logistic regression analyses tested whether sleep disturbance predicted depression (CES-D ≥ 16) at the immediate subsequent visit, and so on over 12 years, in non-depressed HIV+(N = 1054; 9556 personvisits) and non-depressed HIV-(N = 1217; 12,680 person-visits). In HIV+ vs. HIV-MSM, linearly estimated average incidence of depression and normalized cumulative rate of depression over 12 years were compared. Results: In the HIV+ MSM, sleep disturbance was associated with a significant increase in depression 6 months later (OR = 1.6; 95% CI, 1.30, 1.96), which was significantly greater (P b .05) than in HIV-MSM (OR = 1.16; 95% CI, 0.94, 1.44). HIV status and sleep disturbance interacted (P b .001), such that incidence of depression and normalized cumulative rate of depression were greater in HIV+ with sleep disturbance than in HIV+ without sleep disturbance and HIV-groups (all P's b 0.001). Conclusions: HIV+ persons who report sleep disturbance represent a high risk group to be monitored for depression, and possibly targeted for insomnia treatment to prevent depression. Fund: National Institute of Allergy and Infectious Diseases.
doi:10.2139/ssrn.3223923 fatcat:omnil5elkjdnlbcwzm2tfkcfli