The Impact of Insomnia on Pain, Physical Function, and Inflammation in HIV

失眠对 HIV 患者疼痛、身体功能和炎症的影响

• 批准号: 10225460
• 负责人: Burel R. Goodin
• 金额: $ 65.02万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10225460
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; Agreement; Alabama; Anti-Inflammatory Agents; Attention; Biological; Biological Markers; Blood; Centers for Disease Control and Prevention (U.S.); Circadian Dysregulation; DSM-V; Data; Development; Diagnostic; Etiology; Funding; Genomics; Guidelines; HIV; Health; Home; Hyperalgesia; Individual; Inflammation; Inflammation Mediators; Inflammatory; Inflammatory Response; Interleukin-6; Interview; Laboratories; Life; Link; Literature; Maps; Measures; Mediator of activation protein; Methods; Mission; Neurobiology; Pain; Pain Threshold; Participant; Patient Self-Report; Persons; Physical Function; Physiological; Pilot Projects; Polysomnography; Population; Prevalence; Procedures; Process; Public Health; Quality of life; Questionnaires; Research; Research Design; Research Priority; Resources; Risk Factors; Sampling; Severities; Sleep; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Sleeplessness; Standardization; Stimulus; Structure; TNF gene; Testing; Time; United States National Institutes of Health; Universities; Variant; Vulnerable Populations; actigraphy; chronic pain; comorbidity; comparison group; design; diaries; experience; falls; inflammatory marker; innovation; monitoring device; pain sensitivity; pain symptom; physically handicapped; poor sleep; sleep quality; stressor; systemic inflammatory response; therapeutic target; trend

Project Summary/Abstract Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or both, despite adequate opportunity for sleep attainment. As a result, people with insomnia may get too little sleep and/or have poor sleep quality. Insomnia is a common and debilitating sleep disorder in persons living with HIV (PLWH), with prevalence estimates ranging from 30-73%. Insomnia is increasingly viewed as a risk factor for the onset and/or worsening of pain symptoms and physical functioning deficits. Insomnia has been found to promote enhanced pain sensitivity (also known as hyperalgesia), which is critical to the etiology of pain in everyday life. This is particularly relevant for PLWH because recent evidence attests to the fact that pain symptoms are quite prevalent in the daily lives of PLWH. Whether insomnia is a risk factor for the experience of pain and poor physical functioning in PLWH is a topic that has received minimal attention to date; therefore, additional research is needed. Inflammatory processes represent an important biologic mechanism linking insomnia to pain and physical function. Insomnia promotes systemic inflammation as well as inflammatory reactivity to physical stressors like pain. Research conducted with non-HIV samples has shown that inflammation can substantially increase sensitivity to painful stimuli in the laboratory setting, as well as exacerbate pain symptoms in everyday life and physical disability. Taken together, insomnia may drive pain and physical function in PLWH through the proliferation of inflammatory mediators. There is currently a need to elucidate mechanisms and mediators of sleep disorders in PLWH, and the consequences and influences of these disturbances on other HIV-related comorbidities. Accordingly, the overall objective of this proposal is to investigate the impact of insomnia on pain, physical function, and inflammation in PLWH. We will accomplish our overall objective by addressing the following specific aims: 1) determine whether insomnia promotes increased experimental pain sensitivity and exaggerated inflammatory reactivity to painful stimuli in PLWH, and 2) determine if fluctuations in insomnia burden over time drive inflammation and pain in everyday life, and physical functioning among PLWH. These aims will be addressed using study methods developed and rigorously refined by our research team, and which have previously yielded promising preliminary results suggesting that insomnia may indeed promote pain and inflammation in PLWH. This approach is innovative because the impact of insomnia on pain and pain-related inflammatory processes has never before been directly examined in PLWH. Furthermore, the incorporation of objective as well as subjective measures of sleep and physical function, experimental pain testing, and a wide array of pro- and anti-inflammatory biomarkers also contributes to the innovation of this proposal. The proposed research will be significant because, if our hypotheses are confirmed, we will identify: 1) insomnia as a major driver of pain and physical functioning in the laboratory and in everyday life among PLWH, and 2) inflammation as an important insomnia-related mediator of pain in PLWH.

项目摘要/摘要 失眠是一种睡眠障碍，其特征是难以入睡，睡着或两者兼有，尽管足够 睡眠成就的机会。结果，失眠的人睡眠不足和/或睡眠不佳 质量。失眠是患有艾滋病毒（PLWH）患者的常见且令人衰弱的睡眠障碍，患病率 估计范围为30-73％。失眠越来越被视为发病和/或恶化的危险因素 疼痛症状和身体功能缺陷。已经发现失眠是为了增加疼痛 灵敏度（也称为痛觉过敏），这对于日常生活中疼痛的病因至关重要。尤其是 与PLWH相关，因为最近的证据证明了以下事实：疼痛症状在 PLWH的日常生活。失眠是否是疼痛经历和身体功能不佳的危险因素 在PLWH中，一个话题迄今已受到最低关注。因此，需要其他研究。 炎症过程代表了将失眠与疼痛和身体的重要生物学机制 功能。失眠会促进系统性炎症以及对身体压力源（如身体压力）的炎症反应性 疼痛。用非HIV样品进行的研究表明，炎症可以大大增加 在实验室环境中对疼痛刺激的敏感性，以及日常生活中的疼痛症状 身体残疾。综上 炎症介质的增殖。目前有必要阐明 PLWH中的睡眠障碍，以及这些干扰对其他HIV相关的后果和影响 合并症。因此，该提案的总体目标是研究失眠对疼痛的影响， PLWH中的身体功能和炎症。我们将通过解决 以下特定目的：1）确定失眠是否促进了实验性疼痛敏感性的增加和 夸大对PLWH疼痛刺激的炎症反应性，以及2）确定失眠症的波动是否波动 随着时间的流逝，负担推动了日常生活中的炎症和疼痛，以及PLWH之间的身体功能。这些 目标将使用我们的研究团队开发和严格完善的研究方法来解决目标，哪些 以前已经产生了有希望的初步结果，这表明失眠确实可以促进疼痛和 PLWH中的炎症。这种方法具有创新性，因为失眠对疼痛和疼痛有关的影响 炎症过程从未在PLWH中直接检查。此外，合并 目的以及睡眠和身体功能，实验性疼痛测试以及广泛的主观测量 促和抗炎的生物标志物也有助于该提案的创新。提议 研究将是重要的，因为，如果我们的假设得到确认，我们将确定：1）失眠为主要 实验室和PLWH中的日常生活中的疼痛和身体功能的驱动力，2）炎症 作为PLWH中疼痛的重要失眠介质。