Articlegreen2014

Cytokine Polymorphisms are Associated with Poor Sleep Maintenance in Adults Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

Kathryn A. Lee · Caryl Gay · Clive R. Pullinger · Mary Dawn Koenig · Rochelle Zak · Bradley E. Aouizerat

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Abstract

STUDY OBJECTIVES: Cytokine activity and polymorphisms have been associated with sleep outcomes in prior animal and human research. The purpose of this study was to determine whether circulating plasma cytokines and cytokine polymorphisms are associated with the poor sleep maintenance commonly experienced by adults living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). DESIGN: Cross-sectional descriptive study. SETTING: HIV clinics and community sites in the San Francisco Bay area. PARTICIPANTS: A convenience sample of 289 adults (193 men, 73 women, and 23 transgender) living with HIV/AIDS. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: A wrist actigraph was worn for 72 h to estimate the percentage of wake after sleep onset (WASO%) and total sleep time (TST), plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL1B, IL1R2, IL1R2, IL2, IL4, IL6, IL8, IL10, IL13, IL17A), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB1 and NFKB2), and tumor necrosis factor-alpha (TNFA). Controlling for demographic variables such as race and sex, and clinical variables such as CD4+ count and medications, higher WASO% was associated with single nucleotide polymorphisms (SNPs) of IL1R2 rs11674595 and TNFA rs1041981 and less WASO% was associated with IL2 rs2069776. IL1R2 rs11674595 and TNFA rs1041981 were also associated with short sleep duration. CONCLUSIONS: This study strengthens the evidence for an association between inflammation and sleep maintenance problems. In this chronic illness population, cytokine polymorphisms associated with wake after sleep onset provide direction for intervention research aimed at comparing anti-inflammatory mechanisms with hypnotic agents for improving sleep maintenance and total sleep time.

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References

1977The CES-D Scale 1989The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research 1992Automatic Sleep/Wake Identification From Wrist Activity 2002Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia 1998Psychometric evaluation of the pittsburgh sleep quality index 2004Adverse Effects of Modest Sleep Restriction on Sleepiness, Performance, and Inflammatory Cytokines 2008Cardiovascular, Inflammatory, and Metabolic Consequences of Sleep Deprivation 2006Actigraphy Validation with Insomnia

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2016Engagement in care, psychological distress, and resilience are associated with sleep quality among HIV-positive gay, bisexual, and other men who have sex with men 2014Cytokine polymorphisms and plasma levels are associated with sleep onset insomnia in adults living with HIV/AIDS 2016Brief Behavioral Treatment for Insomnia in Persons Living with HIV

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