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: 10258621
• 负责人: Brett M Millar
• 金额: $ 70.8万
• 依托单位: HUNTER COLLEGE
• 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 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10258621
• 关键词: Adherence; Adult; Affect; African American; Age; Alcohol consumption; Anti-Retroviral Agents; Behavioral; Biological; Blood; Blood Pressure; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Chronic; Communities; Complex; Data; Diet; Distal; Enrollment; Ethnic Origin; Exercise; General Population; HIV; Health; Health behavior; Heart; High Density Lipoprotein Cholesterol; Individual; Inflammation; Interleukin-6; Leptin; Link; Longevity; Longitudinal Studies; Lung; Measures; Mediation; Mental Health; Metabolism; Minority; Modeling; Obesity; Observational Study; Outcome; Pathway interactions; Pattern; 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; Viral Load result; Work; actigraphy; adherence rate; aged; behavioral health; cardiovascular disorder risk; cardiovascular health; craving; diaries; ethnic minority population; experience; ghrelin; good diet; health disparity; insight; intersectionality; marginalized population; medication compliance; men; physical conditioning; poor sleep; protective behavior; psychologic; psychosocial; racial and ethnic; racial diversity; racial minority; sexual identity; sexual minority; sleep health; sleep quality; social; social stigma; stressor

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，风险影响 在整个寿命中积累的因素，从老年才开始。越来越多的研究 鉴于越来越多的中年和老年，艾滋病毒患者的心血管健康至关重要 直接对心血管健康的慢性疾病及其对心血管健康的复杂影响，以及 间接通过艾滋病毒对炎症的影响。在一般人群中，睡眠不足或不足 与CVD风险增加有关，部分原因是它对感染和其他生理的影响 机制。 在我们自己的工作中，在患有艾滋病毒的性少数族裔男性中，睡眠不佳也与较低 遵守抗逆转录病毒（ART）药物的速率。因此，研究心血管健康 患有艾滋病毒的人需要特殊考虑从睡眠不良到恶化的艾滋病毒的途径 健康以直接和通过注射直接和间接增加CVD风险（主要是IL-6，TNF-Alpha， 和CRP）。此外，我们假设这有助于睡眠的生理途径的大图 出于CVD风险，是一日级的心理社会行为动态，少数群体压力会影响 随后通过少数压力对睡眠的影响而遵守艺术。根据拟议的 观察性的，对240种种族多样性艾滋病毒的性少数族裔男性的纵向研究，年龄45-64岁，我们 旨在使用纵向数据来测试较差睡眠纵向预测更大的CVD风险的假设 在45-64岁的SMM-LWH中，部分是由于睡眠不良对艾滋病毒健康的影响，部分是通过 睡眠不良对炎症的影响。此外，我们旨在检验日期假设 多种少数族裔压力的来源（性少数派压力，种族/族裔少数派压力和/或） 与艾滋病毒相关的压力）在SMM-LWH操作中对第二天的艺术依从性，部分是通过日期的影响 少数派对睡眠不良的压力。 这项拟议的研究与对睡眠在许多心理中的重要性的认识越来越吻合 行为和身体健康成果，也有助于我们对少数派压力的理解 “在皮肤下”（在这里，通过对睡眠的影响）影响 边缘化身份。