Non-pharmacological interventions to improve sleep quality among people living with HIV: a systematic review and meta-analysis

@article{pujasari2026nonpharmacological,
  title = {{Non-pharmacological interventions to improve sleep quality among people living with HIV: a systematic review and meta-analysis}},
  author = {Hening Pujasari and Yossie Susanti Eka Putri and Eric Umar and Nunung Nurhayati and Friska Friska and A. Saputri Mulyana},
  journal = {BMC Public Health},
  year = {2026},
  month = oct,
  doi = {10.1186/s12889-026-29661-7},
  url = {https://link.springer.com/10.1186/s12889-026-29661-7},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Non-pharmacological interventions to improve sleep quality among people living with HIV: a systematic review and meta-analysis
AU  - Hening Pujasari
AU  - Yossie Susanti Eka Putri
AU  - Eric Umar
AU  - Nunung Nurhayati
AU  - Friska Friska
AU  - A. Saputri Mulyana
PY  - 2026
DA  - 2026/10/03
JO  - BMC Public Health
DO  - 10.1186/s12889-026-29661-7
UR  - https://link.springer.com/10.1186/s12889-026-29661-7
AB  - Background: Sleep disturbances are highly prevalent among people living with HIV (PLWH) and are associated with poor quality of life, suboptimal treatment adherence, and adverse clinical outcomes. Non-pharmacological interventions are increasingly recommended as scalable, low-risk strategies, but their effectiveness in PLWH has not previously been quantitatively synthesized. This review aimed to systematically synthesize this evidence and, where studies were sufficiently comparable, to quantify the pooled effect.  Methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines. Ten electronic databases were searched from inception to October 2025 for randomized and non-randomized studies assessing sleep outcomes (PSQI, ISI, actigraphy, or polysomnography) in PLWH. Two reviewers independently screened studies and extracted data; risk of bias was assessed by design (RoB 2.0 for randomized trials; JBI tools otherwise), judged by domain rather than a single score. Because the eleven eligible studies differed substantially in comparator structure and outcome instrument, quantitative synthesis was restricted a priori to studies with comparable controlled post-intervention PSQI data; remaining evidence was synthesized narratively.  Results: Eleven studies met eligibility criteria. Three randomized trials (Molavi 2020, Qi 2024, Wen 2025; N = 187) had comparable PSQI data and were pooled using a random-effects model. The pooled Hedges g was − 1.38 (95% CI − 1.78 to − 0.99; I² = 27.5%); a Hartung-Knapp sensitivity check, which is more appropriate for a small number of studies, gave a wider but still significant interval (− 2.31 to − 0.48). Leave-one-out analysis retained the direction and significance of the effect after omitting any single study. A study with a mixed pharmacological comparator and studies reporting non-PSQI outcomes were synthesized narratively rather than pooled. With only three pooled studies, publication bias could not be reliably assessed.  Conclusions: Among studies with comparable PSQI data, non-pharmacological interventions were associated with a statistically significant improvement in subjective sleep quality. This pooled evidence base is small (k = 3) and heterogeneous in intervention type; no single category can be established as superior. Findings should be regarded as preliminary pending larger, standardized trials.  Trial registration: This review is registered with PROSPERO (CRD420251176879).
SN  - 1471-2458
ER  -