Agreement between self-reported and objective measures of sleep in people with HIV and lifestyle-similar HIV-negative individuals

Davide De Francesco, Caroline A. Sabin, Alan Winston, Patrick W.G. Mallon, Jane Anderson, Marta Boffito, Nicki D. Doyle, Lewis Haddow, Frank A. Post, Jaime H. Vera, Memory Sachikonye, Susan Redline, Ken M. Kunisaki

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: The aim of this study was to evaluate the agreement between self-reported sleep measures and insomnia with objectively measured sleep parameters in people with HIV (PWH) and HIV-negative individuals.

DESIGN: A cross-sectional analysis of PWH and lifestyle-similar HIV-negative individuals.

METHODS: Self-reported measures included time spent in bed, sleep onset latency and a validated insomnia questionnaire. Objective measures were assessed via 7-days/nights of actigraphy data to determine average and intra-individual variability of several sleep measures (including time spent in bed and onset latency). Spearman's correlation coefficient and Cohen's κ were used to assess the agreement between self-reported and actigraphy-assessed measures. Associations between insomnia and actigraphy-assessed sleep parameters were evaluated using partial least-square discriminant analysis (PLS-DA).

RESULTS: We found fair correlation between self-reported and actigraphy-assessed time spent in bed in 342 PWH (rs = 0.46) and 119 HIV-negative individuals (rs = 0.48). Among PWH, the correlation did not differ by age, education, depressive symptoms and self-reported insomnia (all P > 0.05), but was stronger in men (P = 0.05) and in those with a BMI of at least 25 kg/m2 (P < 0.001). Agreement between self-reported and actigraphy-assessed sleep onset latency was poor in both PWH (κ = 0.002, P = 0.49) and HIV-negative individuals (κ = 0.009, P = 0.65). According to PLS-DA, self-reported insomnia most strongly correlated with intra-individual variability of sleep duration, movement index and efficiency.

CONCLUSION: We report poor-to-fair agreement between self-reported and actigraphy-assessed sleep measures in PWH. Insomnia symptoms correlated with regularity of sleep duration, quality and efficiency. These findings highlight the importance of both patient-reported and objective measures of daily sleep variation, for better understanding sleep disorders in PWH.

Original languageEnglish (US)
Pages (from-to)1051-1060
Number of pages10
JournalAIDS (London, England)
Issue number7
StatePublished - Jun 1 2021

Bibliographical note

Publisher Copyright:
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.


  • Cross-Sectional Studies
  • HIV Infections/complications
  • Humans
  • Life Style
  • Male
  • Self Report
  • Sleep

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Research Support, N.I.H., Extramural


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