Shorter total sleep time is associated with lower CD4+/CD8+ T cell ratios in virally suppressed men with HIV

Author:

Borker Priya V1ORCID,Macatangay Bernard J2,Margolick Joseph B3ORCID,Punjabi Naresh M4,Rinaldo Charles R2,Stosor Valentina5,Hyong-Jin Cho Joshua6,McKay Heather7,Patel Sanjay R1ORCID

Affiliation:

1. Division of Pulmonary Allergy, Critical Care and Sleep Medicine, University of Pittsburgh , Pittsburgh, PA USA

2. Division of Infectious Diseases, University of Pittsburgh , Pittsburgh, PA USA

3. Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA

4. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine , Miami, FL , USA

5. Divisions of Infectious Diseases and Organ Transplantation, Northwestern University , Chicago, IL , USA

6. Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles , Los Angeles, CA USA

7. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA

Abstract

Abstract Study Objectives Although poor sleep quality is associated with lower CD4+ T cell counts among people living with HIV (PLWH), the association between objective sleep metrics and T lymphocyte subset counts is unknown. We evaluated the association between polysomnography (PSG) derived sleep metrics and T lymphocyte subpopulations in a cohort of men living with HIV. Methods Virally suppressed men living with HIV participating in the Multicenter AIDS Cohort Study underwent home overnight PSG. We assessed the association of PSG parameters with CD4+ and CD8+ T cell counts and the CD4+/CD8+ T cell ratio. Results Overall, 289 men with mean (±SD) age 55.3 ± 11.3 years and mean CD4+ T cell count 730 ± 308 cells/mm3 were evaluated. Total sleep time (TST) was significantly associated with CD8+ but not CD4+ T cell counts. After adjusting for age, race, depressive symptoms, antidepressant use, and non-nucleoside reverse transcriptase inhibitors use, every hour of shorter TST was associated with an additional 33 circulating CD8+ T cells/mm3 (p = 0.05) and a 5.6% (p = 0.0007) decline in CD4+/CD8+ T cell ratio. In adjusted models, every hour of shorter rapid eye movement (REM) sleep was associated with an additional 113 CD8+ T cells/mm3 (p = 0.02) and a 15.1% lower CD4+/CD8+ T cell ratio (p = 0.006). In contrast, measures of sleep efficiency and sleep-disordered breathing were not associated with differences in T lymphocyte subpopulations. Conclusions Our findings suggest that shorter TST and REM sleep durations are associated with differences in T lymphocyte subpopulations among men living with HIV. Addressing sleep may reflect a novel opportunity to improve immune function in PLWH.

Funder

National Heart Lung and Blood Institute

National Institutes of Health

Data Analysis and Coordination Center

Office of AIDS Research

Publisher

Oxford University Press (OUP)

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