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

项目概要/摘要： 在美国，大约一半的艾滋病毒感染者（PWH）年龄在50岁及以上。老年 PWH在较早的年龄被诊断患有肥胖、高血压和糖尿病等合并症， 导致更差的健康结果，包括睡眠质量差。睡眠质量差影响高达75%的 PWH并导致不良结局，包括日常活动能力下降和 死亡，但这是一种可改变的行为。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，但有关PWH睡眠卫生习惯的证据有限。 全身炎症标志物IL-10、IL-13、IFN-γ和TNF-α与PWH患者的睡眠障碍相关， 而CRP、TNF-α、IL-1β、IL-6和IL-13与其他共病患者的睡眠质量受损相关， 人口。较少的体力活动与炎症增加有关。集体或互动 睡眠质量差和体力活动少对炎症的影响可能比这两者都要大。 独立因素。反过来，研究身体活动与健康之间的因果关系也是至关重要的。 通过运动干预，睡眠和炎症，以帮助减轻PWH的睡眠质量差。 本研究的目的是通过深入访谈， 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）对睡眠的影响 和炎症。我们提出以下目标： AIM 1.检查老年威尔斯亲王医院的睡眠卫生习惯。 AIM 2.比较HIIT和CME运动干预对老年PWH睡眠的有效性。 AIM 3.量化老年PWH中与睡眠质量相关的炎症标志物（自我报告调查）， 基线（第8周）和运动干预（HIIT和CME）（第16周）之间。 拟议的研究与国家护理研究所（NINR）的使命一致， 支持使用生物标志物评估症状的研究，并使用创新的干预措施来减轻 症状负担我获得K23奖项的短期目标是获得必要的技能和培训， 增加我对睡眠的了解，以及运动干预和炎症在睡眠质量中的作用。 K23奖将使我有一个指导性的培训环境，这将成为我长期- 长期职业目标是成为症状科学发展多模式的独立临床研究者 干预措施，以减轻包括PWH在内的共病患者的睡眠质量差。我的特殊训练 从课程作业到直接运动干预和实验室培训等活动将使我能够 发展新的专业知识。凯斯西储大学提供了一个最佳的环境， 资源和设施，以完成这项拟议的研究，并促进我的短期和长期目标。

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.