Examining objective and subjective sleep measures and neurocognition in older adults with HIV: A cross-sectional study in the deep South

As people live longer with HIV, reports of poor sleep and neurocognitive impairments are expected to increase. Poor sleep and neurocognitive impairments commonly occur in people living with HIV (PLWH) and some medications (e.g., anticholinergics) contribute to these problems. The association between sleep and neurocognition among PLWH taking such medications remains unclear. This study examined trend level associations between neurocognitive domains and subjective and objective sleep outcomes. Among 29 PLWH (<i>M</i>age = 61 years old), the use of anticholinergics and/or antidepressants were examined as a moderator between neurocognition and sleep outcomes. For PLWH taking anticholinergics and/or antidepressants, the associations between insomnia and neurocognitive measures were counter-intuitive, and so were the associations between sleep time and neurocognitive measures. For these adults, objective longer sleep time was associated with poorer verbal learning (immediate, <i>p</i> = .005; delayed recall, <i>p</i> = .002) and visuospatial memory (delayed recall, <i>p</i> = .010). Greater sleep efficiency was associated with better visuospatial memory (immediate, <i>p</i> = .007; delayed recall <i>p</i> = .022). Despite sleep benefits, the use of anticholinergics and/or antidepressants may compromise neurocognitive function in older PLWH. Clinical implications include routine sleep and neurocognitive assessments along with medication monitoring to detect adverse neurocognitive effects of commonly prescribed medications.