The Role of Sleep in Cardiovascular Health Among Men Living with HIV

睡眠对男性艾滋病毒感染者心血管健康的作用

• 批准号: 10523148
• 负责人: Brett M Millar
• 金额: $ 62.68万
• 依托单位: RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-20 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10523148
• 关键词: Adherence; Adult; Affect; African American population; Age; Alcohol consumption; Alcohols; Anti-Retroviral Agents; Behavioral; Biological; Blood; Blood Pressure; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Chronic; Complex; Data; Diet; Distal; Enrollment; Ethnic Origin; Exercise; General Population; HIV; Health; Health Disparities Research; Health behavior; Heart; Heterosexuals; High Density Lipoprotein Cholesterol; Individual; Inflammation; Interleukin-6; Leptin; Link; Longevity; Longitudinal Studies; Lung; Measures; Mediation; Mental Health; Metabolism; Modeling; Obesity; Observational Study; Outcome; Pathway interactions; Pattern; Persons; Pharmaceutical Preparations; Physiological; Population; Process; Public Health; Race; Research; Risk; Risk Factors; Role; Sampling; Self Efficacy; Sexual and Gender Minorities; Skin; Sleep; Sleep Deprivation; Source; Stress; TNF gene; Testing; Tobacco; Unsafe Sex; Viral Load result; Work; actigraphy; adherence rate; aged; behavioral health; cardiovascular disorder risk; cardiovascular health; craving; diaries; ethnic minority; experience; ghrelin; good diet; health disparity; insight; intersectionality; marginalized community; marginalized population; medication compliance; men; minority stress; minority stressor; physical conditioning; poor sleep; protective behavior; psychologic; psychosocial; racial and ethnic; racial diversity; racial minority; sexual identity; sexual minority men; sexual minority stress; sleep health; sleep quality; social; social stigma; theories

Project Summary Cardiovascular disease (CVD) is a major health concern facing the U.S. population, with the impact of risk factors accumulating over the lifespan and beginning well before older age. Increasingly, the study of cardiovascular health for people living with HIV is vital given the growing number of middle- and older-aged adults living with HIV as a chronic condition and its complex effects on cardiovascular health directly, and indirectly through HIV's impact on inflammation. In the general population, poor or inadequate sleep has been linked with increased risk for CVD, in part through its impact on inflammation and other physiological mechanisms. In our own work, among sexual minority men living with HIV, poor sleep has also been linked with lower rates of adherence to antiretroviral (ART) medications. Therefore, the study of cardiovascular health among people living with HIV requires special consideration of the pathways from poor sleep through worsened HIV health to increased CVD risk both directly, and indirectly through inflammation (principally, IL-6, TNF-alpha, and CRP). Further, we hypothesize that, contributing to this larger picture of physiological pathways from sleep to CVD risk, is a day-level psychosocial-behavioral dynamic whereby experiences of minority stress affect subsequent ART adherence through the impact of minority stress on sleep. Accordingly, in the proposed observational, longitudinal study of 240 racially-diverse sexual minority men living with HIV, aged 45-64, we aim to use longitudinal data to test the hypotheses that poor sleep longitudinally predicts greater CVD risk among SMM-LWH aged 45-64, in part through the impact of poor sleep on HIV health, and in part through the impact of poor sleep on inflammation. Additionally, we aim to test the day-level hypothesis that the impact of multiple, intersecting sources of minority stress (sexual minority stress, racial/ethnic minority stress, and/or HIV-related stress) on next-day ART adherence in SMM-LWH operates, in part, through the day-level impact of minority stress on poor sleep. This proposed study aligns with the growing recognition of the importance of sleep in numerous mental, behavioral, and physical health outcomes, and also contributes to our understanding of how minority stress “gets under the skin” (here, through its impact on sleep) to affect physical health outcomes in individuals with marginalized identities.

项目摘要 心血管疾病（CVD）是美国人口面临的主要健康问题， 这些因素在人的一生中积累，并在老年之前就开始了。越来越多的研究 鉴于越来越多的中老年人，艾滋病毒感染者的心血管健康至关重要 成年艾滋病毒感染者作为一种慢性病及其对心血管健康的直接复杂影响， 间接通过HIV对炎症的影响。在一般人群中，睡眠不足或睡眠不足一直是 与心血管疾病风险增加有关，部分原因是它对炎症和其他生理 机制等 在我们自己的工作中，在感染艾滋病毒的性少数男性中，睡眠不足也与较低的 坚持抗逆转录病毒药物治疗的比率。因此，对人群心血管健康的研究 艾滋病毒感染者需要特别考虑从睡眠不足到艾滋病毒恶化的途径 健康直接和间接通过炎症（主要是IL-6，TNF-α， CRP）。此外，我们假设，有助于从睡眠到睡眠的生理途径的这一更大的图片， 心血管疾病风险，是一个日常水平的心理社会行为动态，其中少数民族的压力影响的经验， 通过少数民族压力对睡眠的影响，随后的ART坚持。因此，在拟议的 一项对240名年龄在45-64岁之间的不同种族性少数男性艾滋病毒感染者进行的观察性纵向研究，我们 旨在使用纵向数据来检验睡眠质量差纵向预测心血管疾病风险更高的假设 在45-64岁的SMM-LWH中，部分原因是睡眠不良对艾滋病毒健康的影响，部分原因是 睡眠不良对炎症的影响此外，我们的目标是测试一天的水平假设， 少数民族压力的多重交叉来源（性少数民族压力，种族/少数民族压力，和/或 艾滋病毒相关的压力）对第二天坚持抗逆转录病毒治疗的SMM-LWH运作，部分是通过一天的影响， 少数人强调睡眠不好。 这项拟议中的研究与人们越来越认识到睡眠在许多精神疾病中的重要性相一致， 行为和身体健康结果，也有助于我们理解少数民族的压力是如何产生的。 “深入皮肤”（这里，通过其对睡眠的影响）影响个体的身体健康结果， 边缘化的身份。