Associations between widespread pain and sleep quality in people with HIV.

BACKGROUND We investigate the association of widespread pain with sleep quality among people with HIV (PWH) and HIV-negative controls. SETTING UK-based cohort. METHODS Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in >4 of 5 body regions and in >7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later though 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal-Wallace tests and linear/logistic regression considered associations between pain extent and sleep quality. RESULTS Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Whilst there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7-16), 55.3 (48.0-58.9) and 57.2 (48.9-61.3) respectively for those with widespread pain, 8 (4-13), 51.2 (45.5-58.3) and 50.3 (43.6-56.1) for those with regional pain, and 5 (2-9), 47.9 (42.9-54.3) and 45.5 (41.4-50.3) for those with no pain (all p-values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms. CONCLUSIONS Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in PWH.