Sleep Fatigue & Cognitive Correlates in Pediatric HIV

睡眠疲劳

• 批准号: 6876009
• 负责人: Daniel S Lewin
• 金额: $ 43.64万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-24 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6876009
• 关键词: HIV infections; REM sleep; actigraphy; adolescence (12-20); arousal; behavioral /social science research tag; child psychology; clinical research; cognition; developmental neurobiology; fatigue; human immunodeficiency virus 1; human subject; leukocyte count; middle childhood (6-11); neuropsychological tests; neuropsychology; pain; pediatric AIDS; polysomnography; psychological stressor; psychometrics; psychomotor function; quality of life; questionnaires; sleep disorders; virus load

DESCRIPTION (provided by applicant): Sleep disturbance and fatigue emerge during the first phase of HIV infection. Given the increased life span of HIV infected patients, and evidence that sleep is necessary for optimal physical and mental health, investigation of the links between HIV and sleep are critically important. Sleep has been implicated as playing a role in brain development and is known to be necessary for optimal immune function, learning, and memory. Therefore, the deterioration of sleep and prominence of fatigue may be particularly deleterious for HIV infected pediatric patients, the majority of whom are first exposed to the virus in utero. There may be significant implications for developmental changes in the brain and sleep may be a high priority target for early intervention. As there is only one published report on pediatric HIV and sleep, the general aim of this study is to use objective assessment techniques (i.e., polysomnography (PSG)) to describe sleep abnormalities in children with HIV. Specific aims include: 1) to describe abnormalities in the organization of sleep stages and to estimate prevalence rates of sleep disorders in HIV infected pediatric patients; and 2) to use objective laboratory based measures of sleep propensity, fatigue and neurocogntive function in HIV infected pediatric patients to describe the daytime disability that has been documented in adult HIV+ patients. The study sample will be 130 children with HIV, and an age matched sample of healthy (seronegative) controls ages 4 to 18 years. All patients will be studied with PSG, Multiples Sleep Latency Tests and performance tests that measure fatigue and sleepiness. Fifty subjects: from each group will also be evaluated with a battery of neurocognitive measures that are sensitive to fatigue and the effects of sleep disruption. Regression analyses and tests of group differences will be used to establish an association between HIV and sleep abnormalities that are linked directly to measures of HIV severity and neurocognitive outcomes. This study is a necessary first step for future studies that will identify specific changes in the brain and in neuroendocrine factors that are the hypothesized mediators of the association between HIV infection, sleep disturbance, and disability. This study will advance clinical science by identifying targets of intervention that will improve children's quality of life, and physical and mental health.

描述（由申请人提供）： HIV 感染的第一阶段会出现睡眠障碍和疲劳。鉴于艾滋病毒感染者的寿命延长，并且有证据表明睡眠对于最佳身心健康是必要的，因此研究艾滋病毒与睡眠之间的联系至关重要。睡眠在大脑发育中发挥着重要作用，并且对于最佳免疫功能、学习和记忆至关重要。因此，睡眠质量的恶化和疲劳的加剧对于感染艾滋病毒的儿科患者可能特别有害，他们中的大多数人在子宫内就首次接触到该病毒。这可能对大脑的发育变化产生重大影响，而睡眠可能是早期干预的高度优先目标。由于目前只有一份关于儿科 HIV 与睡眠的报告，本研究的总体目标是使用客观评估技术（即多导睡眠图 (PSG)）来描述 HIV 儿童的睡眠异常。具体目标包括： 1) 描述睡眠阶段组织的异常情况并估计 HIV 感染儿科患者睡眠障碍的患病率； 2) 使用基于实验室的客观测量方法来测量 HIV 感染儿科患者的睡眠倾向、疲劳和神经认知功能，以描述成年 HIV+ 患者中记录的日间残疾情况。研究样本将包括 130 名 HIV 感染儿童，以及年龄匹配的 4 至 18 岁健康（血清阴性）对照样本。所有患者都将接受 PSG、多重睡眠潜伏期测试和测量疲劳和困倦的性能测试的研究。每组的五十名受试者也将接受一系列对疲劳和睡眠中断影响敏感的神经认知指标进行评估。回归分析和群体差异测试将用于建立艾滋病毒和睡眠异常之间的关联，该关联与艾滋病毒严重程度和神经认知结果的测量直接相关。这项研究是未来研究中必要的第一步，未来的研究将确定大脑和神经内分泌因素的具体变化，这些变化是艾滋病毒感染、睡眠障碍和残疾之间关联的假设介质。这项研究将通过确定改善儿童生活质量和身心健康的干预目标来推进临床科学。