Depression and anxiety mediate the association between sleep quality and health-related quality of life in people living with HIV

Depression and anxiety mediate the association between sleep quality and health-related quality of life in people living with HIV. Download PDF Abstract Sleep disturbances are highly prevalent among people living with HIV (PWH) and frequently co-occur with psychiatric comorbidities such as depression and anxiety. Although these factors independently predict health-related quality of life (HRQoL), the extent to which psychiatric symptoms explain the relationship between sleep quality and HRQoL—particularly within the Chinese context—remains unclear.

Understanding these pathways is critical for optimizing holistic HIV care. We conducted a cross-sectional study involving 426 PWH attending outpatient clinics in Nanning, China, between January and September 2024. Participants completed the Sleep Quality Scale (SQS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the MOS-HIV Health Survey.

Multivariable linear regression and restricted cubic spline models were employed to examine the association between sleep quality and HRQoL. Parallel mediation analyses were later performed to quantify the mediating roles of depression and anxiety. After adjusting for sociodemographic and clinical covariates, better sleep quality was independently associated with higher HRQoL (adjusted B = 1.59 per unit increase in SQS, 95% CI 1.03–2.14), exhibiting an about linear dose–response relationship.

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