Relationship of Formal Exercise Interventions, Sleep, and Inflammation Markers in People Living with HIV

项目摘要/摘要： 在美国，大约一半的艾滋病毒携带者(PWH)的年龄在50岁及以上。更老的 PWH在较早的年龄被诊断出患有肥胖症、高血压和糖尿病等共病， 会导致较差的健康结果，包括睡眠质量较差。睡眠质量差影响高达75%的 PWH并导致不良结果，包括日常活动绩效下降和增加 死亡，但这是一种可以改变的行为。睡眠卫生习惯(即卧室环境、睡眠时间表、 咖啡因)会影响睡眠质量，但关于PWH患者的睡眠卫生习惯的证据有限。 全身炎症标志物IL-10、IL-13、干扰素-γ和肿瘤坏死因子-α与慢性阻塞性肺疾病睡眠障碍有关。 而C反应蛋白、肿瘤坏死因子-α、IL-1β、IL-6和IL-13与睡眠质量受损有关 人口。体力活动减少与炎症增加有关。集体的或互动的 睡眠质量差和体力活动水平低对炎症的影响可能比任何一种都要强 独立因素。反过来，研究体力活动之间关系的因果路径也是至关重要的 通过运动干预，减少睡眠和炎症，以帮助缓解威斯康星医院睡眠质量差的问题。 本研究的目的是通过对老年人进行深入访谈，了解老年人的睡眠卫生习惯。 为了了解患者对睡眠质量的看法，并描述两种锻炼的效果 高强度间歇训练(HIIT)和持续中等强度运动(CME)对睡眠的干预 以及老年PWH中的炎症。我们提出以下目标： 目的1.检查老年威斯康星医院的睡眠卫生习惯。 目的2.比较HIIT和CME运动干预对老年PWH患者睡眠的影响。 目的3.量化与睡眠质量相关的炎症标记物(自我报告调查) 基线，在(第8周)和运动干预(HIIT和CME)之后(第16周)之间。 拟议的研究与国家护理研究所(NINR)的使命是一致的 支持使用生物标记物评估症状和使用创新干预措施缓解症状的研究 症状负担。我对K23奖项的短期目标是获得必要的技能和培训，以 增加关于睡眠的知识，以及运动干预和炎症在睡眠质量中所起的作用。 K23大奖将让我有一个有指导的培训环境，作为我长期- 成为症状科学独立临床研究员的任期职业目标发展多模式 干预措施，以减轻包括PWH在内的共病条件下睡眠质量差的情况。我的特殊训练 活动，从课程作业到直接的运动干预和实验室培训，将使我能够 发展新的专业知识。凯斯西储大学提供了一个最优的环境， 资源和设施，以完成这项拟议的研究，并促进我的近期和长期目标。

Project Summary/Abstract: Approximately half of all people living with HIV (PWH) in the United States are age 50 years and older. Older PWH are diagnosed with comorbidities such as obesity, hypertension, and diabetes at an earlier age, which contributes to poorer health outcomes including poor sleep quality. Poor sleep quality affects up to 75% of PWH and leads to poor outcomes, including decrease in performance of daily activities and increased mortality, but is a modifiable behavior. Sleep hygiene habits (i.e. bedroom environment, sleep schedule, caffeine) can impact sleep quality, but limited evidence exists regarding sleep hygiene habits in PWH. Systemic inflammation markers IL-10, IL-13, IFN-y, and TNF-α are associated with sleep disturbance in PWH, while CRP, TNF-α, IL-1β, IL-6, and IL-13 are associated with impaired sleep quality in other comorbid populations. Less physical activity is associated with increased inflammation. The collective or interacting impact of poor sleep quality and low levels of physical activity on inflammation may be stronger than either independent factor. In turn, it is vital to examine the causal pathway of the relation between physical activity through exercise interventions, sleep and inflammation in order to help mitigate poor sleep quality in PWH. The purpose of this study is to examine sleep hygiene habits in older PHW through in-depth interviews in order to understand the patient perspective of sleep quality and to characterize the effects of two exercise interventions, high-intensity interval training (HIIT) and continuous moderate-intensity exercise (CME), on sleep and inflammation in older PWH. We propose the following aims: AIM 1. Examine sleep hygiene habits in older PWH. AIM 2. Compare the effectiveness of HIIT and CME exercise interventions on sleep in older PWH. AIM 3. Quantify inflammation markers associated with sleep quality (self-report surveys) in older PWH at baseline, between (week 8) and after exercise interventions (HIIT and CME) (week 16). The proposed research is consistent with the National Institute for Nursing Research (NINR) mission to support research which uses biomarkers to assess symptoms and use of innovative interventions to mitigate symptom burden. My short-term goal for the K23 award is to acquire the necessary skills and training to increase my knowledge about sleep and the role exercise interventions and inflammation play in sleep quality. The K23 award will allow me to have a mentored training environment that will serve as a pathway to my long- term career goal of becoming an independent clinical investigator in symptom science developing multimodal interventions to mitigate poor sleep quality across comorbid conditions, including PWH. My specific training activities, ranging from coursework to direct exercise intervention and laboratory training, will allow me to develop new expertise. Case Western Reserve University provides an optimal environment with the necessary resources and facilities to complete this proposed research and facilitate my immediate and long term goals.