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