Sleep Fatigue & Cognitive Correlates in Pediatric HIV

描述（由申请人提供）： 睡眠障碍和疲劳出现在艾滋病毒感染的第一阶段。鉴于艾滋病毒感染者的寿命延长，以及睡眠对最佳身心健康是必要的证据，调查艾滋病毒和睡眠之间的联系至关重要。睡眠被认为在大脑发育中发挥作用，并且已知对于最佳免疫功能，学习和记忆是必要的。因此，睡眠的恶化和疲劳的突出可能对HIV感染的儿科患者特别有害，他们中的大多数人在子宫内首次暴露于病毒。这可能对大脑的发育变化有重大影响，睡眠可能是早期干预的高度优先目标。由于只有一份关于儿童艾滋病毒和睡眠的已发表报告，本研究的总体目的是使用客观评估技术（即，多导睡眠图（PSG））来描述HIV感染儿童的睡眠异常。具体目标包括：1）描述睡眠阶段组织的异常，并估计HIV感染儿科患者的睡眠障碍患病率; 2）使用基于客观实验室的HIV感染儿科患者的睡眠倾向、疲劳和神经认知功能测量，描述已在成人HIV+患者中记录的日间残疾。研究样本将是130名HIV感染儿童，以及年龄匹配的4至18岁健康（血清阴性）对照样本。所有患者都将接受PSG、多重睡眠潜伏期测试和测量疲劳和嗜睡的性能测试。50名受试者：还将用一系列对疲劳和睡眠中断的影响敏感的神经认知测量来评估每组的受试者。将使用回归分析和组差异检验来建立HIV与睡眠异常之间的关联，这些异常与HIV严重程度和神经认知结果的测量直接相关。这项研究是未来研究的必要的第一步，这些研究将确定大脑和神经内分泌因子的特定变化，这些因子是HIV感染，睡眠障碍和残疾之间关联的假设介质。这项研究将通过确定干预目标来促进临床科学，从而改善儿童的生活质量和身心健康。

DESCRIPTION (provided by applicant): Sleep disturbance and fatigue emerge during the first phase of HIV infection. Given the increased life span of HIV infected patients, and evidence that sleep is necessary for optimal physical and mental health, investigation of the links between HIV and sleep are critically important. Sleep has been implicated as playing a role in brain development and is known to be necessary for optimal immune function, learning, and memory. Therefore, the deterioration of sleep and prominence of fatigue may be particularly deleterious for HIV infected pediatric patients, the majority of whom are first exposed to the virus in utero. There may be significant implications for developmental changes in the brain and sleep may be a high priority target for early intervention. As there is only one published report on pediatric HIV and sleep, the general aim of this study is to use objective assessment techniques (i.e., polysomnography (PSG)) to describe sleep abnormalities in children with HIV. Specific aims include: 1) to describe abnormalities in the organization of sleep stages and to estimate prevalence rates of sleep disorders in HIV infected pediatric patients; and 2) to use objective laboratory based measures of sleep propensity, fatigue and neurocogntive function in HIV infected pediatric patients to describe the daytime disability that has been documented in adult HIV+ patients. The study sample will be 130 children with HIV, and an age matched sample of healthy (seronegative) controls ages 4 to 18 years. All patients will be studied with PSG, Multiples Sleep Latency Tests and performance tests that measure fatigue and sleepiness. Fifty subjects: from each group will also be evaluated with a battery of neurocognitive measures that are sensitive to fatigue and the effects of sleep disruption. Regression analyses and tests of group differences will be used to establish an association between HIV and sleep abnormalities that are linked directly to measures of HIV severity and neurocognitive outcomes. This study is a necessary first step for future studies that will identify specific changes in the brain and in neuroendocrine factors that are the hypothesized mediators of the association between HIV infection, sleep disturbance, and disability. This study will advance clinical science by identifying targets of intervention that will improve children's quality of life, and physical and mental health.