K23NR019744

Relationship of Formal Exercise Interventions, Sleep, and Inflammation Markers in People Living with HIV - 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-A are associated with sleep disturbance in PWH, while CRP, TNF-A, IL-1SS, 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.

Case Western Reserve University

NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLE'S NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE WHOLE LIFE COURSE. SCIENCE SUPPORTED BY THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) USES THIS HOLISTIC PERSPECTIVE TO IMPROVE INDIVIDUAL AND POPULATION HEALTH AND ADVANCE HEALTH EQUITY. NINR-SUPPORTED RESEARCH PROMOTES HEALTH AND WELL-BEING BY ADDRESSING NEEDS AT MULTIPLE LEVELS INDIVIDUAL, FAMILY, COMMUNITY, AND SOCIETAL LEVELS AND DEVELOPING TREATMENT AND PREVENTION STRATEGIES THAT ARE RESPONSIVE TO THE REALITY OF PEOPLE'S LIVES. NURSES KNOW PEOPLE, AND PEOPLE TRUST NURSES. PATIENT AND FAMILIES INTERACT WITH NURSES MORE THAN ANY OTHER CLINICIANS. NURSING SCIENCE USES THIS SPECIAL RELATIONSHIP TO BETTER UNDERSTAND PATIENTS, FAMILIES, AND COMMUNITIES AND THE MANY FACTORS THAT INFLUENCE THEIR HEALTH. NURSING SCIENCE SUPPORTED BY NINR USES THIS KNOWLEDGE TO DEVELOP STRATEGIES FOR IMPROVING HEALTH AND WELLNESS ACROSS POPULATIONS, HEALTH CARE SETTINGS, AND THE LIFESPAN, WITH AN EMPHASIS ON ACHIEVING HEALTH EQUITY. NINR-SUPPORTED SCIENTISTS HAVE DEVELOPED INTERVENTIONS FOR: SUPPORTING PARENTS OF PREMATURE INFANTS, PROMOTING HIV PREVENTION IN UNDERSERVED POPULATIONS, IMPROVING TRANSITIONAL CARE LEADING TO BETTER OUTCOMES AND COST-SAVINGS, AND HELPING INNER-CITY CHILDREN MANAGE ASTHMA. NURSING SCIENCE TRANSCENDS THE BOUNDARIES OF DISEASE AND RESEARCH DISCIPLINES TO BETTER UNDERSTAND THE EXPERIENCES OF INDIVIDUALS AND FAMILIES LIVING WITH ILLNESS AND TO DEVELOP PERSONALIZED APPROACHES THAT MAXIMIZE HEALTH AND WELL-BEING FOR INDIVIDUALS AT ALL STAGES OF LIFE, ACROSS DIVERSE POPULATIONS AND SETTINGS. NINR-SUPPORTED SCIENCE USES NURSING SCIENCE'S UNIQUE, PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO ADVANCE OUR UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH: THOSE FACTORS THAT ARE AT THE ROOT OF THE INEQUITIES THAT WE SEE, SUCH AS FOOD INSECURITY AND ACCESS TO HEALTHCARE. NINR RESEARCH EFFORTS IN WELLNESS INVESTIGATE THE KEY BIOLOGICAL, BEHAVIORAL, AND SOCIAL FACTORS THAT PROMOTE LONG-TERM HEALTH AND HEALTHY BEHAVIORS AND PREVENT THE DEVELOPMENT OF ILLNESS ACROSS HEALTH CONDITIONS, SETTINGS, AND THE LIFESPAN. RESEARCH IN WELLNESS IS ALSO FOCUSED ON DEVELOPING AND TESTING CULTURALLY APPROPRIATE INTERVENTIONS TO PROMOTE HEALTH AND PREVENT ILLNESS IN MINORITY AND UNDERSERVED GROUPS. NINR ALSO SUPPORTS SCIENCE TO ASSIST INDIVIDUALS, FAMILIES, AND HEALTH CARE PROFESSIONALS IN MANAGING ADVANCED, SERIOUS ILLNESS, AND PLANNING FOR END-OF-LIFE DECISIONS. IN ADDITION, NINR PROMOTES TECHNOLOGICAL ADVANCEMENTS THAT ADDRESS A RANGE OF HEALTH CARE CHALLENGES AND FACILITATE THE DELIVERY OF REAL-TIME PERSONALIZED INFORMATION TO INDIVIDUALS AND FAMILIES, HEALTH CARE PROVIDERS, AND COMMUNITIES. FINALLY, NINR HAS A LONGSTANDING AND CONTINUING COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAM MEMBERS WHO WILL CARRY THE FIELD OF NURSING SCIENCE INTO THE FUTURE. IN ORDER TO PREPARE AN INNOVATIVE, DIVERSE, AND TALENTED NEXT GENERATION OF NURSE SCIENTISTS, NINR SUPPORTS A VARIETY OF TRAINING OPPORTUNITIES FOR SCIENTISTS AND TRAINEES AT ALL CAREER LEVELS, PARTICULARLY THOSE AT AN EARLY CAREER STAGE WHO ARE SO CRITICAL TO SUSTAINING THE FUTURE OF INNOVATIVE RESEARCH AND HIGH QUALITY HEALTH CARE.

93.361 - Nursing Research

National Institute of Nursing Research (NINR) [HHS - NIH]

Ohio United States

State-Wide

Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required) (PA-20-206)

Amendment Since initial award the End Date has been extended from 03/31/24 to 03/31/25 and the total obligations have increased 199% from $131,220 to $392,580.