B-24 Objective and Subjective Sleep Measures are Associated with Neurocognition in Middle-Aged and Older Adults With and Without HIV

Abstract

Abstract Objective Poorer sleep quality is related to worse cognitive functioning in the general population and people living with HIV; however, many studies use self-report sleep questionnaires that rely on retrospective recall. This study aimed to examine the relationship between objective (wrist actigraphy) and subjective sleep quality with neurocognitive functioning. Method Eighty-five adults aged 50-74 years with and without HIV (HIV+ n = 53, HIV- n = 32) were recruited from the community and ongoing studies at UC San Diego. Participants completed comprehensive neuropsychological testing assessing global and domain-specific cognition. Participants wore actigraphy watches for 14 nights after neuropsychological testing to objectively assess sleep quality (i.e., total sleep time (TST), efficiency, wake after sleep onset, and sleep fragmentation). The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Results After adjusting for demographic variables and use of sleep medications, there were no differences in any sleep quality measures by HIV status (p’s>0.05). In separate adjusted linear regression models, lower sleep efficiency (p = 0.02; 95% CI: -9.5, -1.1) and greater sleep fragmentation (p = 0.02; 95% CI: -0.82, -0.09) were associated with worse learning. Less TST was associated with worse working memory (p = 0.02; 95% CI: -9.2, -0.8). In contrast, worse subjective sleep quality was associated with worse executive function (p < 0.01; 95% CI: -1.18, -0.23) and working memory (p = 0.03; 95% CI: -1.22, -0.07). Conclusion Both objective and subjective sleep quality were associated with cognition in both persons with and without HIV; however, subjective and objective sleep quality were associated with different cognitive domains. Therefore, both objective and subjective sleep quality are important health behaviors to assess.