Exploring the complexity of sleep disturbances in persons with HIV/AIDS.

Sleep disturbances are influenced by physiological, psychological, and environmental factors. Many persons living with HIV/AIDS manifest a variety of sleep disorders. Although completion of a brief sleep assessment can be helpful to determine the presence of a sleep problem, more in-depth investigation is necessary when sleep problems are reported. This pilot work used an open-ended interview guide developed from elements of Hauri's comprehensive sleep history. A convenience sample of six HIV-positive clients was interviewed during January 1997. In addition to answering open-ended questions about sleep-wake patterns, participants completed the Pittsburgh Sleep Quality Index and a personal characteristics form. HIV-severity information was obtained from the medical record. A complete sleep evaluation includes a thorough history and physical assessment, with a special focus on underlying pathology and medication use such as over-the-counter drugs, vitamins and herbal products, and mood-altering substance use. Treatment plans can include instruction about a variety of cognitive behavioral strategies. The nurse plays a major role in assessing, evaluating, teaching, and referring, which can contribute to identification of strategies that can improve quality of life.