Understanding and managing disordered sleep in people with HIV

People with HIV experience higher burden of cardiometabolic, mood, and cognitive disorders. Poor-quality and insufficient sleep are both associated with increased risk for these comorbidities and are more common in people with HIV. Although previous reviews have explored the prevalence and risk factors for sleep complaints in people with HIV, few have differentiated these complaints by potential underlying causes. Disordered sleep in people with HIV might arise from HIV-specific sleep disruptors, including direct effects of the virus, chronic inflammation, and antiretroviral treatment. There is also evidence that sleep is more fragile in people with HIV and some common sleep disorders, such as obstructive sleep apnoea, chronic insomnia, and circadian rhythm disorders, might be particularly problematic in people with HIV. Understanding how HIV uniquely disrupts sleep physiology could inform the development of tailored, mechanism-based management strategies to improve sleep health in people with HIV.