Using Sleep Health to Optimize Smoking Cessation Treatment Response in HIV-Positive Adults

摘要 父母补助金：心血管疾病（CVD）是成年人发病和死亡的主要原因， 艾滋病毒（ALHIV）和吸烟是该人群中最重要的可改变的CVD风险因素。 现有戒烟干预措施的成功率相对较低。睡眠不好更普遍 在吸烟者中，ALHIV更为普遍，可能是由戒烟尝试引起的， 复发到以前的吸烟模式，并代表了一个平行的发病途径，包括增加 心血管疾病（CVD）在ALHIV。因此，不健康的睡眠可能会使戒烟更 困难和增加心血管风险和其他健康状况不佳的ALHIV。然而，睡眠不好是 非药物干预是可行的，我们小组的一项试点研究表明， 干预增加戒烟率时，添加到常规戒烟治疗。到 评估我们的睡眠训练方法对改善睡眠健康和促进戒烟的有效性 率ALHIV，拟议的研究将补充一个药物支持的戒烟计划（6- 会议，15周的咨询计划与伐尼克兰）与睡眠训练方法，以减少吸烟 （STARS）为吸烟者制定的干预措施。将STARS与一般健康（GH）教育进行比较 控制该研究将招募N=200名有兴趣戒烟的ALHIV吸烟者。他们将被随机分配到 使用STARS（N=100）或GH（N=100）戒烟。该研究将测量STARS的疗效 与GH相比，改善客观测量的健康睡眠指标，评估其对戒烟的影响， 以及心血管疾病风险的其他指标，并确定认知和情感变量是否介导了心血管疾病的发生。 睡眠健康与戒烟之间的关系这些研究结果将提供实用的 信息以及如何利用睡眠健康来优化吸烟的机械见解 ALHIV的治疗。 补充：这种多样性补充包括研究和培训部分。培训部分 将为候选人提供必要的指导和发展经验， 申请K奖。研究部分将招募干预无反应者进入一个 基于接受和承诺疗法（ACT）的新型吸烟和睡眠干预。研究旨在 补充的内容包括（1）确定在无应答者中进行干预的可行性和可接受性 ALHIV，以及（2）确定干预对戒烟率，睡眠健康， 和心血管健康。 .

Abstract Parent Grant: Cardiovascular disease (CVD) is a major cause of morbidity and mortality in adults living with HIV (ALHIV), and cigarette smoking is the single most important modifiable CVD risk factor in this population. Success rates for existing smoking cessation interventions are relatively low. Poor sleep is more prevalent among smokers, more prevalent among ALHIV, can be caused by smoking cessation attempts, predicts relapse to former smoking patterns, and represents a parallel pathway to morbidity including increased cardiovascular disease (CVD) among ALHIV. Thus, unhealthy sleep may make smoking cessation more difficult and increase cardiovascular risk and other poor health conditions in ALHIV. Yet, poor sleep is amenable to nonpharmacologic interventions, and a pilot study from our group revealed that a sleep health intervention increased smoking cessation rates when added to routine smoking cessation treatment. To evaluate the efficacy of our sleep training approach to improve sleep health and increase smoking cessation rates in ALHIV, the proposed study will supplement an empirically-supported smoking cessation program (6- session, 15-week counseling program with varenicline) with a Sleep Training Approach to Reducing Smoking (STARS) intervention developed for smokers. STARS will be compared to a General Health (GH) educational control. The study will recruit N=200 ALHIV smokers who are interested in quitting. They will be randomized to smoking cessation with either STARS (N=100) or GH (N=100). The study will measure the efficacy of STARS versus GH to improve objectively measured healthy sleep metrics, assess its impact on smoking cessation as well as other metrics of CVD risk, and determine whether cognitive and affective variables mediate the association between sleep health and smoking cessation. Results of these studies will provide practical information as well as mechanistic insight into how sleep health can be leveraged to optimize smoking cessation treatment in ALHIV. Supplement: This diversity supplement includes research and training components. The training component will provide the candidate with the mentorship and development experiences necessary to successfully compete for a K award application. The research component will recruit intervention non-responders into a novel smoking and sleep intervention based on Acceptance and Commitment Therapy (ACT). Research aims of the supplement include (1) Determine the feasibility and acceptability of the intervention in non-responder ALHIV, and (2) Determine the preliminary efficacy of the intervention for smoking cessation rates, sleep health, and cardiovascular health. .