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Dozing or Napping Has Bigger Cognitive Impact in People With HIV
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11th International Workshop on HIV & Aging Virtual Meeting, September 30 to October 2, 2020
By Mark Mascolini for NATAP and Virology Education
In a big UK analysis HIV-positive and negative people who reported daytime sleepiness (dozing) or daytime sleeping (napping) had worse cognitive performance in four domains analyzed [1]. HIV infection independently amplified the impact of dozing or napping in one neurocognitive domain, reaction time (information-processing speed).
Insomnia and obstructive sleep apnea affect higher proportions of people with than without HIV, according to researchers from Brigham and Women's Hospital and other Boston centers who ran the dozing/napping study. Research links excessive daytime dozing and napping to worse cognitive performance in non-HIV populations, but their impact in people with HIV remains largely uncharted.
To address these questions the Boston team studied more than a half million 40- to 69-year-old men and women in the UK Biobank. All participants give blood and urine samples and complete extensive testing of cognitive function, vascular reactivity, visual acuity, body composition, and physical fitness. Cognitive tests cover four domains: reaction time, pairs matching, fluid intelligence, and prospective memory. The researcher identified Biobank participants with HIV via ICD-10 codes or self-reported noncancer illness codes.
For the dozing/napping analysis, researchers focused on 560 people with HIV and 500,539 without HIV recruited from 2006 through 2010. Age averaged 50.5 in the HIV group and 56.5 in the HIV-negative group. Respective proportions of women were 24.8% and 54.5%, nonwhites 21.6% and 5.5%, and people with a college education 40.2% and 32.1%.
Compared with HIV-negative people, those with HIV reported significantly more frequent daytime dozing or napping. Multivariate regression models adjusted for age, sex, ethnicity, college education, socioeconomic status, and physical activity level significantly linked daytime sleepiness (dozing) and napping to worse performance in all four cognitive domains: reaction time, pairs matching, fluid intelligence, and prospective memory. These associations remained significant both for people who reported dozing or napping "sometimes" or "often."
People with HIV performed significantly worse than the HIV-negative group in reaction time and pairs matching. The slowed reaction time in people with HIV looked equivalent to the impact of 4 additional years in age, and the worse pairs matching worked out to 8 additional years of age. Finally, HIV infection significantly worsened the impact of both daytime sleepiness (dozing) (P = 0.002) and daytime napping (P = 0.007) on reaction time.
For the first time, the researchers concluded, this study shows that "HIV infection interacts with disturbed daytime sleep behavior to adversely affect cognitive performance."
Reference
1. Li P, Gao L, Montano M, Hu K. Daytime sleep behavior and cognitive performance in middle-older aged HIV+ and HIV- adults: a cross-sectional study of 502,505 participants in UK Biobank. 11th International Workshop on HIV & Aging Virtual Meeting, September 30 to October 2, 2020. Abstract 1.
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