Background

Poor sleep is a major complaint of people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and undergoing methadone maintenance therapy (MMT). We tested the impact of three different sleep-improving interventions (trazodone; sleep hygiene training; sleep hygiene training + trazodone) on sleep, psychological functioning and biomarkers in males with HIV and undergoing MMT.

Methods

A total of 75 male outpatients (mean age: 39.6 years) participated in a 12 week intervention. Participants were randomly assigned to one of the following conditions: trazodone 50 mg/d (TRAZ); sleep hygiene training (SHT); sleep hygiene training and trazodone (SHT + TRAZ). At baseline, and six and 12 weeks later, participants completed questionnaires covering subjective sleep and daytime sleepiness, and symptoms of depression and anxiety. In parallel, their cognitive performance (working memory; sustained attention) was assessed. Biomarkers (cortisol, BNDF, CD4⁺) were assessed at baseline and at the end of the study.

Results

Over time, sleep disturbances decreased and daytime functioning and overall sleep quality improved. More specifically, both sleep disturbances and daytime functioning improved in the two SHT conditions from baseline to week 6. Daytime functioning remained stable from week 6 to week 12. Over time, in all conditions symptoms of depression and anxiety declined from baseline to week 6 and remained lower from week 6 to week 12. Daytime sleepiness, symptoms of insomnia and sleep-disordered breathing remained unchanged. Sustained attention performance improved over time from baseline to week 6 and remained high through to week 12. Biomarkers remained unchanged.

Conclusions

In males with HIV and undergoing MMT, treating sleep disturbances over a period of six to 12 weeks had a positive impact on aspects of sleep disturbance, symptoms of depression and anxiety, and cognitive performance. The results indicate that sleep hygiene training, either as stand-alone or in combination with trazodone, can produce positive results.

中文翻译：

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美沙酮维持疗法对患有艾滋病毒/艾滋病的人的睡眠障碍的治疗对睡眠，心理和认知功能以及生物标志物的影响。

背景

睡眠不足是患有人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合症（AIDS）并正在接受美沙酮维持治疗（MMT）的人们的主要抱怨。我们测试了三种不同的睡眠改善干预措施（曲唑酮；睡眠卫生训练；睡眠卫生训练+曲唑酮）对患有艾滋病毒且正在接受MMT的男性的睡眠，心理功能和生物标志物的影响。

方法

共有75名男性门诊患者（平均年龄：39.6岁）参加了为期12周的干预。参与者被随机分配到以下条件之一：曲唑酮50 mg / d（TRAZ）；睡眠卫生训练（SHT）；睡眠卫生培训和曲唑酮（SHT + TRAZ）。在基线以及六周和十二周后，参与者完成了问卷调查，涵盖主观睡眠和白天嗜睡以及抑郁和焦虑症状。同时，评估他们的认知表现（工作记忆；持续关注）。在基线和研究结束时评估生物标志物（皮质醇，BNDF，CD4 ⁺）。

结果

随着时间的流逝，睡眠障碍会减少，白天的功能和整体睡眠质量会得到改善。更具体地说，从基线到第6周，这两种SHT条件下的睡眠障碍和白天功能都得到改善。从第6周到第12周，白天功能保持稳定。随着时间的推移，在所有条件下，抑郁和焦虑症状从基线到第6周均下降，并且从第6周到第12周仍保持较低水平。白天嗜睡，失眠症状和睡眠呼吸紊乱保持不变。从基线到第6周，持续的注意力表现随时间而改善，直到第12周仍保持高水平。生物标志物保持不变。

结论

在患有艾滋病毒且正在接受MMT治疗的男性中，治疗6至12周的睡眠障碍对睡眠障碍，抑郁和焦虑症状以及认知能力有积极影响。结果表明，单独或与曲唑酮联合进行的睡眠卫生培训均可产生积极的效果。