Increased risk of depression in non-depressed HIV infected men with sleep disturbance: Prospective findings from the Multicenter AIDS Cohort StudyResearch in context
Michael R. Irwin,
Gemma Archer,
Richard Olmstead,
Todd T. Brown,
Linda A. Teplin,
Sanjay R. Patel,
Alison G. Abraham,
Elizabeth C. Breen
Affiliations
Michael R. Irwin
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Boulevard, UCLA, David Geffen School of Medicine, Los Angeles, CA 90095, United States; Corresponding author at: Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, 300 Medical Plaza #3109, Los Angeles, CA 90095, United States.
Gemma Archer
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Boulevard, UCLA, David Geffen School of Medicine, Los Angeles, CA 90095, United States
Richard Olmstead
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Boulevard, UCLA, David Geffen School of Medicine, Los Angeles, CA 90095, United States
Todd T. Brown
Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University, 1830 East, Monument Street, Suite 333, Baltimore, MD, 21287, United States
Linda A. Teplin
Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Infectious Disease, 710 N. Lake Shore Drive, Chicago, IL 60657, United States
Sanjay R. Patel
Center for Sleep and Cardiovascular Outcomes Research, Department of Medicine, University of Pittsburgh, 3459 Fifth Avenue, NW 628 MUH, Pittsburgh, PA 15213, United States
Alison G. Abraham
Department of Ophthalmology, Johns Hopkins School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States
Elizabeth C. Breen
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Boulevard, UCLA, David Geffen School of Medicine, Los Angeles, CA 90095, United States
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 (>2 weeks) and depressive symptoms (Clinical Epidemiologic 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 person-visits) 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 < .05) than in HIV- MSM (OR = 1.16; 95% CI, 0.94, 1.44). HIV status and sleep disturbance interacted (P < .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 < 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. Keywords: Insomnia, Sleep disturbance, Depression, Human immunodeficiency virus (HIV), Inflammation
