Sleep, Aging, and HIV Infection Cohort Study

睡眠、衰老和 HIV 感染队列研究

• 批准号: 9243122
• 负责人: KEN M. KUNISAKI
• 金额: $ 56.8万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9243122
• 关键词: Address; Adult; Affect; Age; Age-Years; Aging; Anti-Retroviral Agents; Biometry; Brain; Cardiovascular Diseases; Characteristics; Chronic; Clinical; Cohort Studies; Comorbidity; Cross-Sectional Studies; Data; Development; Drowsiness; Drug Kinetics; Elderly; Enrollment; Epidemiology; Fatigue; Future; General Population; HIV; HIV Infections; Health; High Prevalence; Home environment; Hypoxemia; Impaired cognition; Impairment; Inflammation; Intervention; Intervention Studies; Ireland; Knowledge; Link; Longitudinal cohort study; Lung diseases; Measures; Medicine; Muslim religion; Obesity; Obstructive Sleep Apnea; Outcome; Oxygen; Oxygen saturation measurement; Participant; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Polysomnography; Population; Prevalence; Quality of life; Questionnaires; Reporting; Resources; Respiration Disorders; Risk; Risk Factors; Sample Size; Sampling; Site; Sleep; Sleep Disorders; Sleep Fragmentations; Sleep disturbances; Sleeplessness; Stress; Symptoms; Targeted Research; Time; Translational Research; United Kingdom; Wrist; actigraphy; age effect; aged; base; cognitive function; cognitive testing; demographics; design; disorder risk; endothelial dysfunction; high risk; immune activation; improved; indexing; longitudinal design; multidisciplinary; nocturnal Hypoxemia; novel; performance tests; public health relevance; sleep abnormalities

 DESCRIPTION (provided by applicant): Antiretroviral (ARV) medications now allow persons living with HIV (PLWH) to age into late adulthood, although quality of life often remains impaired, in part due to development of chronic health problems. PLWH commonly report fatigue, insomnia, and poor sleep quality, though must studies of sleep in PLWH have been small, single-center studies. Obstructive sleep apnea (OSA) has not been well studied in PLWH, despite the increasing prevalence of OSA risk factors such as obesity and older age in PLWH. OSA and its associated intermittent nocturnal hypoxemia have also been associated with comorbidities commonly seen in PLWH, such as cardiovascular disease and cognitive impairment. Our preliminary data suggest that OSA is underdiagnosed in PLWH and that the presence of OSA is a strong predictor of fatigue symptoms. Although aging clearly increases OSA risk in the general population, the effect of aging on OSA risk in PLWH is unknown. Whether OSA and sleep fragmentation predict other clinical outcomes in PLWH, such as cognitive impairment, also remains unknown. Our study will address this knowledge gap by leveraging the ongoing Pharmacokinetic and Clinical Observations in People Over Fifty (POPPY) observational cohort study (NCT01737047) and quantify sleep in three groups of POPPY participants: PLWH >50 years of age (n=250), PLWH <50 years of age (n=125), and HIV negative controls >50 years of age (n=125). We will use wrist-worn, ambulatory overnight oximetry and actigraphy to characterize intermittent nocturnal hypoxemia, sleep efficiency, sleep duration, and other objective sleep measures. We will use questionnaires to assess patient-reported sleep outcomes. We will determine the prevalence of sleep abnormalities in older PLWH. We will also determine the relationships between objective sleep data, patient-reported sleep outcomes, and cognitive test performance, while leveraging the unique POPPY design to understand how aging and HIV affect such relationships. Lastly, we will determine how sleep abnormalities relate to immune activation, systemic inflammation, and endothelial dysfunction in PLWH. We have organized a multi- disciplinary team of experts in HIV-associated lung and breathing disorders, sleep epidemiology, HIV medicine, HIV translational science, and HIV epidemiology to implement this study. To our knowledge, our study will be the first to comprehensively characterize objective sleep data in PLWH, especially older PLWH, with adequate sample size, multi-site representation, and appropriate controls to determine how aging and HIV infection affect these measures. This cross-sectional study will inform the design of longitudinal cohort studies and future trials targeted at sleep interventions to improve quality of life and other clinical outcomes for PLWH.

 描述（由适用提供）：抗逆转录病毒（ARV）药物现在允许患有艾滋病毒（PLWH）的人到成年后期，尽管生活质量通常仍然受到损害，部分原因是慢性健康问题的发展。 PLWH通常报告疲劳，失眠和睡眠质量不佳，尽管PLWH中的睡眠研究必须是小的单中心研究。阻塞性睡眠呼吸暂停（OSA）在PLWH中的研究尚未很好地研究，因此OSA危险因素（例如肥胖症和PLWH年龄较大）的患病率不断增加。 OSA及其相关的间歇性夜间低氧血症也与PLWH中常见的合并症有关，例如心血管疾病和认知障碍。我们的初步数据表明，OSA在PLWH中的诊断不足，OSA的存在是疲劳症状的有力预测指标。尽管衰老显然增加了普通人群的OSA风险，但衰老对PLWH中OSA风险的影响尚不清楚。 OSA和睡眠破碎化是否可以预测PLWH中其他临床结果（例如认知障碍）也是未知的。我们的研究将通过利用五十多个（罂粟）观察队列研究的人的持续药代动力学和临床观察来解决这一知识差距，并在三组罂粟参与者中进行量化睡眠：PLWH> 50岁> 50岁（n = 250）（n = 250），PLWH <50岁，年龄（n = 125岁）和HIV对照（n = 125岁）和50岁（50岁）和50年（> 50年）。我们将使用腕上的卧床过夜血氧仪和行摄影，以表征间歇性夜间低氧血症，睡眠效率，睡眠持续时间和其他客观睡眠指标。我们将使用问卷来评估患者报告的睡眠结果。我们将确定较老的PLWH的睡眠异常的患病率。我们还将确定客观睡眠数据，患者报告的睡眠结果和认知测试表现之间的关系，同时利用独特的罂粟设计来了解衰老和HIV如何影响这种关系。最后，我们将确定睡眠异常与PLWH中的免疫激活，全身感染和内皮功能障碍有关。我们已经组织了一支由HIV相关肺和呼吸障碍，睡眠流行病学，HIV医学，HIV转化科学和HIV流行病学的多学科专家团队，以实施这项研究。据我们所知，我们的研究将是第一个全面表征PLWH中的客观睡眠数据，尤其是较旧的PLWH，具有足够的样本量，多站点表示和适当的控制，以确定衰老和HIV感染如何影响这些测量结果。这项横断面研究将为纵向队列研究和针对睡眠干预措施的未来试验的设计提供信息，以提高质量 生命和其他PLWH的临床结果。