Sleep Fatigue & Cognitive Correlates in Pediatric HIV

睡眠疲劳

• 批准号: 7095324
• 负责人: Daniel S Lewin
• 金额: $ 47.13万
• 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/7095324
• 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）： 在HIV感染的第一阶段，睡眠障碍和疲劳出现。鉴于艾滋病毒感染患者的寿命增加，并且证据表明睡眠对于最佳的身心健康是必需的，因此对艾滋病毒与睡眠之间的联系至关重要。睡眠已被暗示是在大脑发育中起作用，对于最佳免疫功能，学习和记忆是必要的。因此，对于HIV感染的小儿患者，睡眠恶化和疲劳的突出可能特别有害，大多数人首先暴露于子宫内病毒。对大脑的发育变化可能有重大影响，睡眠可能是早期干预的高优先级目标。由于只有一份关于小儿艾滋病毒和睡眠的报告，因此这项研究的总体目的是使用客观评估技术（即多摄取术（PSG））来描述艾滋病毒儿童的睡眠异常。具体目的包括：1）描述睡眠阶段组织中的异常情况，并估计艾滋病毒感染的小儿患者的睡眠障碍患病率； 2）使用基于目标实验室的睡眠倾向，疲劳和神经认知功能的基于目标实验室的测量，以描述成人HIV+患者已记录的白天残疾。该研究样本将是130名HIV儿童，与4至18岁的健康（血​​清调节）对照相匹配。将对所有患者进行PSG，倍数的睡眠潜伏期测试以及测量疲劳和嗜睡的性能测试。五十名受试者：每组也将通过一系列对疲劳敏感的神经认知度量和睡眠破坏的影响进行评估。群体差异的回归分析和测试将用于建立HIV和睡眠异常之间的关联，这些异常与HIV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的必要第一步，它将确定大脑的特定变化以及神经内分泌因素，这些变化是HIV感染，睡眠障碍和残疾之间相关性的假设介体。这项研究将通过确定将改善儿童生活质量以及身心健康的干预目标来提高临床科学。