Household energy poverty and sleep disorders among people living with HIV: Does the level of physical activity have any moderating effect?

Objectives Household energy poverty has been associated with deleterious health outcomes, including poor sleep outcomes. However, no study has examined this relationship among people living with HIV (PLHIV) and the possible moderating effect of physical activity. Therefore, this study investigated the relationship between household energy poverty and sleep disorders and assessed whether various levels of physical activity (vigorous, moderate, and minimal) would moderate this relationship among PLHIV in Kenya. Methods Data for this study were drawn from the Resource Insecurity and Well-being Study on PLHIV in Kenya (N = 1,132), which included information on Insomnia, household energy poverty, a measure of physical activity levels, and demographic measures. Following univariate and bivariate analysis, we conducted multivariate linear regressions followed by interaction models with each level of physical activity. Results Of the 1132 participants, 74.2% had energy poverty scores above the mean (18.15), and 36.6% reported Insomnia scores of 7.03 and above. In the multivariate model, household energy poverty was associated with greater insomnia scores ({beta} = 0.10, 95% CI: 0.07, 0.12). Vigorous, moderate, and minimal physical activity were disparately associated with lower insomnia scores. Interactions between household energy poverty and physical activity were not statistically significant, although the model suggested a buffering effect. Conclusion Household energy poverty increases Insomnia, and engaging in any level of physical activity reduces Insomnia among PLHIV. Physical activity has the potential to buffer the effects of energy poverty on Insomnia. These findings suggest that public health interventions should address both structural and lifestyle factors to improve sleep outcomes in vulnerable populations.