Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 1;99(4):379-387.
doi: 10.1097/QAI.0000000000003668.

Poor Sleep Quality is Associated With Frailty Among Women With and Without HIV

Anjali Sharma  1 , Donald R Hoover  2 , Qiuhu Shi  3 , Elizabeth Daubert  4 , Deborah L Jones  5 , Bradley E Aouizerat  6 , Deborah Gustafson  7 , Seble G Kassaye  8 , Elizabeth Topper  9 , Catalina Ramirez  10 , Sushma K Cribbs  11 , Deborah Konkle Parker  12 , Audrey L French  13 , Kathleen M Weber  4
Affiliations

Poor Sleep Quality is Associated With Frailty Among Women With and Without HIV

Anjali Sharma et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Poor sleep and frailty are prevalent among aging women with HIV (WWH). Although poor sleep quality has been associated with frailty in general aging populations, these relationships are not well characterized among WWH.

Methods: Among 1001 WWH and 371 women without HIV (WWoH) aged older than 40 years with Pittsburgh Sleep Quality Index (PSQI) and Fried Frailty Phenotype data, we analyzed relationships of poor sleep quality (PSQI>5) and sleep quality components with frailty. Separate hierarchical regression models evaluated associations between sleep and frailty status (prefrail vs. robust, frail vs robust) adjusting for the following: (1) study site and HIV status, (2) demographics, (3) substance use/central nervous system-active medications, (4) comorbidities, and (5) depressive symptoms.

Results: The median age was 53 years; 9.2% were frail while 52.8% were prefrail. Poor sleep quality was frequent (52% WWH vs. 47% WWoH; P = 0.07) and associated with double the frailty odds independent of HIV status, after adjusting for depressive symptoms (fully adjusted odds ratio AOR 1.99, 95% CI: 1.14 to 3.50, P = 0.016). Sleep-associated daytime dysfunction and very poor sleep efficiency were independently associated with being frail. Poor self-rated sleep quality and higher use of sleep medications were independently associated with being prefrail.

Conclusions: Among midlife WWH and WWoH, poor subjective sleep measures are independently associated with higher frailty odds. Longitudinal studies are needed to understand how aspects of sleep may affect progression from prefrailty to frailty after accounting for comorbidities and to elucidate the complex relationships between comorbidities and frailty, with sleep quality among midlife PWH.

Keywords: HIV; aging; frailty; sleep; women.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

    1. Hawkins KL, Brown TT, Margolick JB, et al. Geriatric syndromes: new frontiers in HIV and sarcopenia. Aids. 2017;31suppl 2:S137–S146.
    1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Ser A Biol Sci Med Sci. 2001;56:M146–M156.
    1. Althoff KN, Jacobson LP, Cranston RD, et al. Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men. J Gerontol Ser A, iol Sci Med Sci. 2014;69:189–198.
    1. Fatukasi TV, Edmonds A, Gustafson DR, et al. Prevalence and 1-year incidence of frailty among women with and without HIV in the Women's Interagency HIV Study. AIDS. 2019;33:357–359.
    1. Kojima G. Frailty as a predictor of future falls among community-dwelling older people: a systematic review and meta-analysis. J Am Med Directors Assoc. 2015;16:1027–1033.

LinkOut - more resources