ORCID Profile
0000-0002-9911-9436
Current Organisations
Universidade de São Paulo
,
Northumbria University
,
Lunds Universitet
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Publisher: American Academy of Sleep Medicine (AASM)
Date: 09-03-2021
DOI: 10.5664/JCSM.9214
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.SMRV.2021.101571
Abstract: Antiretroviral therapy has significantly reduced morbidity and mortality in people living with HIV (PLWH). However, a direct consequence of higher survival is the development of ageing-related co-morbidities that have considerable potential to affect quality of life. Sleep disturbances in PLWH are a significant source of morbidity. A meta-analysis has estimated the prevalence of self-reported sleep disturbances in PLWH to be 58%, with commonly identified disturbances including insomnia, obstructive sleep apnoea and poor sleep quality. Not only do sleep disturbances impair daytime functioning, but chronic sleep disruption also associates with metabolic dysregulation and cardiometabolic disease. Therefore, an understanding of the pathogenesis of sleep disturbances in PLWH is important for reducing morbidity and improving quality of life. Several pathophysiological processes in HIV infection may cause sleep-wake dysregulation. In early infection stages, immunological changes such as expression of sleep-promoting cytokines could mediate sleep disturbances. Long term, chronic immune activation, in addition to side effects of antiretroviral therapy, may impact sleep homeostasis more severely, for ex le through increasing the risk of obstructive sleep apnoea. These sleep disturbances may further contribute to an inflammatory state, due to the bi-directional relationship between sleep and immunity. In summary, further elucidating the link between HIV, immune activation, and sleep is an underexplored avenue for minimising population morbidity and mortality.
Publisher: Wiley
Date: 06-11-2022
DOI: 10.1111/JPI.12838
Abstract: The increasing number of people living with human immunodeficiency virus, HIV, (PLWH) have an elevated incidence of risk for noncommunicable comorbidities, the aetiology of which remains incompletely understood. While sleep disturbances are often reported in PLWH, it is unknown to what extent they relate to changes in the circadian and/or sleep homeostatic processes. We studied the relationship between sleep characteristics, circadian phase, and HIV status in older adults from the HAALSI (Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community in South Africa) subs le of the Agincourt Health and Demographic Surveillance System in South Africa ( n = 187, 36 human immunodeficiency virus positive [HIV+], age: 66.7 ± 11.5 years, range 45—93 years), where HIV prevalence is high and (in contrast to the global north) does not associate significantly with potentially confounding behavioural differences. In participants with valid actigraphy data ( n = 172), regression analyses adjusted for age and sex indicated that HIV+ participants had slightly later sleep onset ( β = .16, p = .039), earlier sleep offset times ( β = −.16, p = .049) and shorter total sleep times ( β = −.20, p = .009) compared to the HIV negative (HIV−) participants. In a subset of participants ( n = 51, 11 HIV+), we observed a later dim light melatonin onset (DLMO) in HIV+ (21:16 ± 01:47) than in HIV− (20:06 ± 00:58) participants ( p = .006). This substantial difference remained when adjusted for age and sex ( β = 1.21 p = .006). In 36 participants (6 HIV+) with DLMO and actigraphy data, median phase angle of entrainment was −6 min in the HIV+ group and +1 h 25 min in the HIV− group. DLMO time correlated with sleep offset ( ρ = 0.47, p = .005) but not sleep onset ( ρ = −0.086, p = .623). Collectively, our data suggest that the sleep phase occurred earlier than what would be biologically optimal among the HIV+ participants. This is the first report of a mistimed circadian phase in PLWH, which has important potential implications for their health and well‐being, especially given the well‐established relationships between circadian asynchrony and sleep deprivation with poorer health outcomes.
Publisher: Springer Science and Business Media LLC
Date: 23-11-2018
DOI: 10.1038/S41598-018-35584-0
Abstract: As part of the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated sleep habits and their interactions with HIV or non-communicable diseases (NCDs) in 5059 participants (median age: 61, interquartile range: 52—71, 54% females). Self-reported sleep duration was 8.2 ± 1.6h, and bed and rise times were 20:48 ± 1:15 and 05:31 ± 1:05 respectively. Ratings of insufficient sleep were associated with older age, lack of formal education, unemployment, and obesity (p 0.05). Ratings of restless sleep were associated with being older, female, having more education, being unemployed, and single. Hypertension was associated with shorter self-reported sleep duration, poor sleep quality, restless sleep, and periods of stopping breathing during the night (p 0.05). HIV positive in iduals not on antiretroviral treatment (ART) reported more nocturnal awakenings than those on ART (p = 0.029) and HIV negative in iduals (p = 0.024), suggesting a negative net effect of untreated infection, but not of ART, on sleep quality. In this cohort, shorter, poor-quality sleep was associated with hypertension, but average self-reported sleep duration was longer than reported in other regions globally. It remains to be determined whether this is particular to this cohort, South Africa in general, or low- to middle-income countries undergoing transition.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 11-2021
DOI: 10.5664/JCSM.9614
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Malcolm von Schantz.