0916 Sleep Diagnosis, Polysomnography Findings, and CPAP Adherence in People Living with HIV and Controls

Abstract Introduction Human Immunodeficiency Virus (HIV) infection remains a significant health challenge, particularly due to the global effects on health, social impact, and overall well-being. Studies on people living with HIV (PLWH) have identified that sleep disturbance interfere with quality of life, medication effect, comorbidities and disease progression, however, there is scarcity on sleep studies presenting objective polysomnographic (PSG) data and adherence to CPAP. In the current study we present clinical and PSG data in PLWH. Methods Observational, longitudinal study on PLWH and controls referred to a single sleep center due to suspicion of OSA. A home sleep apnea test (HSAT), full night PSG, or split night study. All PLWH were on combination antiretroviral therapy. Data obtained included clinical history, sleep study data, Epworth sleepiness and CPAP adherence at the first follow up visit. Results A total of 62 PLWH (48 male, 14 female) and 156 controls (91 male, 65 female) were included. In the PLWH, 30 patients underwent HSAT, 15 full diagnostic PSG, and 17 split night studies. In the PLWH group, 89% had OSA, 63% insomnia, 40% restless sleep and 21% restless legs syndrome. Data from the 32 lab studies showed statistically increased periodic limb movement index (PLMI) in PLWH (mean±SD) 33.8±31.73 than controls 10.7±17.41. A significantly higher number of PLWH had PLMI >15 hour than controls in the titration part of the study (64.7% vs. 35.5%, respectively; chi-square 3.85, p < 0.05). There were no other statistically significant differences in the sleep parameters. Adherence to CPAP was completed in 41 PLWH and 95 controls. Finally, pooling together all studies, PLWH showed lower adherence to CPAP (61.4±33.63% vs. 79.0±26.90%, respectively, t-value -3.248, p< 0.0015) and shorter time of its use (4.9±2.44 hours vs. 5.7±1.93 hours, respectively, t-value -2.038, p < 0.044) than controls. Conclusion This study shows that PLWH have elevated frequency of OSA, insomnia, restless sleep and restless legs syndrome. Objective data with in-lab studies surprisingly showed increased index of PLMS, not resolving with titration. Follow up on patients with OSA showed lower adherence to CPAP than controls. Support (if any)