Nevertheless, their findings have made a tremendous impact because changes in sleep are an important and persistent clinical symptom of HIV infection. Here some of these investigators review their The precise mechanism by which HIV alters sleep is unknown. Nevertheless, as reviewd by Opp and colleagues, there is a substantial body of work at the basic research level implicating cytokines in sleep regulation. Increased levels of cytokines are associated with the pathophysiology of HIV and they are most likkely to also contribute to the sleep disturbances associated with the HIV infection. Opp and colleagues detail their interesting new findings with HIV-gp120, a glycoprotein that is the binding site for the virus.
Important gaps remain.
There are no details about sleep in acute HIV infection. In fact, there is no objective assessment of sleepiness with the MSLT in acute HIV infection. More research is needed on the effects of viral infections on sleep. Data is beginning to emerge that sleep deprivation affects immunocompetence. How this is done is unknown.