Sensor and Survey Measures Associated With Daily Fatigue in HIV: Findings From a Mixed-Method Study.
Mary Beth Makic, Danielle Gilbert, Catherine Jankowski and 4 others
PMID 31860594WHAT IT FOUND
People with HIV had fatigue above average on 66% of survey days, varying daily.
Less activity, higher resting heart rate, more time asleep, stress, avoidance coping and low mood were associated with fatigue. Sensors revealed sleep problems patients had not noticed.
Key findings
01Participants reported fatigue above the population mean on 66% of survey days, and their scores varied substantially from day to day.
02On days with more steps and active minutes, fatigue was lower; lower resting or minimum heart rate, higher maximum heart rate, and higher heart rate variability were also associated with less fatigue.
03More time in bed, more total sleep, higher sleep efficiency, and more light or deep sleep were associated with greater fatigue, and participants often did not recognize their sleep problems until sensor data were shown.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 55 participants were studied, and they came from one Colorado HIV clinic. Most were men and White non-Hispanic, so findings may not apply to women, African American or Latino/Latina people with HIV. The study only looked for associations over 30 days. It did not test whether changing activity, sleep, stress, coping or medication reduced fatigue. Many tests were run without correction for false positives, so some relationships may be chance. Participants were selected because they had at least mild fatigue and suppressed HIV, so fatigue may be overestimated compared with all people with HIV. Fitbit devices may underestimate activity intensity, overestimate steps or active minutes, overestimate sleep quality, and use nonpublic algorithms for sleep stages and resting heart rate. Sleep stage data were valid on only 711 of 1,618 monitoring days (44%), and survey fatigue data were available on 943 of 1,618 days (59%). Qualitative interviews were done with the first 25 participants, not all 55, and some people declined because of daily surveys, sensors or outdated smartphones. Because activity and fatigue were measured on the same day, the study cannot tell whether less activity caused more fatigue or more fatigue caused less activity.
Declared interests
The paper lists NIH extramural and non-U.S. government research support. It says sponsorships or competing interests are disclosed at the end of the article, but the supplied text does not include the actual disclosure statement.
The easy way to misread this
Do not read these associations as proof that exercise, sleep changes, or stress management reduce HIV fatigue. The study only measured relationships on the same days, did not test an intervention, and some findings may be chance because no correction was made for multiple tests.