Self-reported sleep disturbance is associated with lower CD4 count and 24-h urinary dopamine levels in ethnic minority women living with HIV

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Abstract

Background: Sleep disturbance is associated with dopamine dysregulation, which can negatively impact immune status. Individuals living with HIV experience more sleep difficulties, and poor sleep may compound immune decrements associated with HIV infection. Little research has examined associations between sleep, dopamine, and immune status (CD4 count) in individuals with HIV. As ethnic minority women living with HIV (WLWH) are at heightened risk for HIV disease progression, we related sleep reports to both CD4 count and dopamine levels in a cohort of ethnic minority WLWH. Methods: Participants were 139 low-income WLWH (ages 20-62; 78.3% African-American or Caribbean) who reported both overall sleep quality and sleep disturbance on the Pittsburgh sleep quality index (PSQI). CD4 count and HIV viral load were measured via morning peripheral venous blood samples, and concentrations of dopamine were measured via 24-h urine collection. Covariates included HIV viral load, length of time since HIV diagnosis, HAART adherence, perceived stress and depression. Results: After controlling for all covariates, greater sleep disturbance was associated with significantly lower CD4 count (β= -20, p= .03) and lower levels of dopamine (β= -25, p= .04). Poorer overall sleep quality was marginally associated with lower CD4 count (β= -16, p= .08), and was not associated with dopamine. Conclusion: Our analyses suggest that sleep disturbance is independently related with immune status and dopamine levels in WLWH. Lower levels of dopamine may indicate neuroendocrine dysregulation and may impact immune and health status. Results highlight sleep disturbance rather than overall sleep quality as potentially salient to neuroendocrine and immune status in ethnic minority WLWH.

Original languageEnglish
Pages (from-to)2647-2653
Number of pages7
JournalPsychoneuroendocrinology
Volume38
Issue number11
DOIs
StatePublished - Nov 1 2013

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CD4 Lymphocyte Count
Dopamine
Sleep
HIV
Viral Load
Urine Specimen Collection
Highly Active Antiretroviral Therapy
African Americans
Health Status
HIV Infections
Disease Progression
Depression

Keywords

  • CD4 count
  • Dopamine
  • HIV
  • Sleep

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Endocrine and Autonomic Systems

Cite this

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title = "Self-reported sleep disturbance is associated with lower CD4 count and 24-h urinary dopamine levels in ethnic minority women living with HIV",
abstract = "Background: Sleep disturbance is associated with dopamine dysregulation, which can negatively impact immune status. Individuals living with HIV experience more sleep difficulties, and poor sleep may compound immune decrements associated with HIV infection. Little research has examined associations between sleep, dopamine, and immune status (CD4 count) in individuals with HIV. As ethnic minority women living with HIV (WLWH) are at heightened risk for HIV disease progression, we related sleep reports to both CD4 count and dopamine levels in a cohort of ethnic minority WLWH. Methods: Participants were 139 low-income WLWH (ages 20-62; 78.3{\%} African-American or Caribbean) who reported both overall sleep quality and sleep disturbance on the Pittsburgh sleep quality index (PSQI). CD4 count and HIV viral load were measured via morning peripheral venous blood samples, and concentrations of dopamine were measured via 24-h urine collection. Covariates included HIV viral load, length of time since HIV diagnosis, HAART adherence, perceived stress and depression. Results: After controlling for all covariates, greater sleep disturbance was associated with significantly lower CD4 count (β= -20, p= .03) and lower levels of dopamine (β= -25, p= .04). Poorer overall sleep quality was marginally associated with lower CD4 count (β= -16, p= .08), and was not associated with dopamine. Conclusion: Our analyses suggest that sleep disturbance is independently related with immune status and dopamine levels in WLWH. Lower levels of dopamine may indicate neuroendocrine dysregulation and may impact immune and health status. Results highlight sleep disturbance rather than overall sleep quality as potentially salient to neuroendocrine and immune status in ethnic minority WLWH.",
keywords = "CD4 count, Dopamine, HIV, Sleep",
author = "Julia Seay and McIntosh, {Roger C} and Fekete, {Erin M.} and Fletcher, {Mary Ann} and Mahendra Kumar and Neil Schneiderman and Antoni, {Michael H}",
year = "2013",
month = "11",
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doi = "10.1016/j.psyneuen.2013.06.022",
language = "English",
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journal = "Psychoneuroendocrinology",
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TY - JOUR

T1 - Self-reported sleep disturbance is associated with lower CD4 count and 24-h urinary dopamine levels in ethnic minority women living with HIV

AU - Seay, Julia

AU - McIntosh, Roger C

AU - Fekete, Erin M.

AU - Fletcher, Mary Ann

AU - Kumar, Mahendra

AU - Schneiderman, Neil

AU - Antoni, Michael H

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Background: Sleep disturbance is associated with dopamine dysregulation, which can negatively impact immune status. Individuals living with HIV experience more sleep difficulties, and poor sleep may compound immune decrements associated with HIV infection. Little research has examined associations between sleep, dopamine, and immune status (CD4 count) in individuals with HIV. As ethnic minority women living with HIV (WLWH) are at heightened risk for HIV disease progression, we related sleep reports to both CD4 count and dopamine levels in a cohort of ethnic minority WLWH. Methods: Participants were 139 low-income WLWH (ages 20-62; 78.3% African-American or Caribbean) who reported both overall sleep quality and sleep disturbance on the Pittsburgh sleep quality index (PSQI). CD4 count and HIV viral load were measured via morning peripheral venous blood samples, and concentrations of dopamine were measured via 24-h urine collection. Covariates included HIV viral load, length of time since HIV diagnosis, HAART adherence, perceived stress and depression. Results: After controlling for all covariates, greater sleep disturbance was associated with significantly lower CD4 count (β= -20, p= .03) and lower levels of dopamine (β= -25, p= .04). Poorer overall sleep quality was marginally associated with lower CD4 count (β= -16, p= .08), and was not associated with dopamine. Conclusion: Our analyses suggest that sleep disturbance is independently related with immune status and dopamine levels in WLWH. Lower levels of dopamine may indicate neuroendocrine dysregulation and may impact immune and health status. Results highlight sleep disturbance rather than overall sleep quality as potentially salient to neuroendocrine and immune status in ethnic minority WLWH.

AB - Background: Sleep disturbance is associated with dopamine dysregulation, which can negatively impact immune status. Individuals living with HIV experience more sleep difficulties, and poor sleep may compound immune decrements associated with HIV infection. Little research has examined associations between sleep, dopamine, and immune status (CD4 count) in individuals with HIV. As ethnic minority women living with HIV (WLWH) are at heightened risk for HIV disease progression, we related sleep reports to both CD4 count and dopamine levels in a cohort of ethnic minority WLWH. Methods: Participants were 139 low-income WLWH (ages 20-62; 78.3% African-American or Caribbean) who reported both overall sleep quality and sleep disturbance on the Pittsburgh sleep quality index (PSQI). CD4 count and HIV viral load were measured via morning peripheral venous blood samples, and concentrations of dopamine were measured via 24-h urine collection. Covariates included HIV viral load, length of time since HIV diagnosis, HAART adherence, perceived stress and depression. Results: After controlling for all covariates, greater sleep disturbance was associated with significantly lower CD4 count (β= -20, p= .03) and lower levels of dopamine (β= -25, p= .04). Poorer overall sleep quality was marginally associated with lower CD4 count (β= -16, p= .08), and was not associated with dopamine. Conclusion: Our analyses suggest that sleep disturbance is independently related with immune status and dopamine levels in WLWH. Lower levels of dopamine may indicate neuroendocrine dysregulation and may impact immune and health status. Results highlight sleep disturbance rather than overall sleep quality as potentially salient to neuroendocrine and immune status in ethnic minority WLWH.

KW - CD4 count

KW - Dopamine

KW - HIV

KW - Sleep

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U2 - 10.1016/j.psyneuen.2013.06.022

DO - 10.1016/j.psyneuen.2013.06.022

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EP - 2653

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

IS - 11

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