title: Cytokine polymorphisms are associated with poor sleep maintenance in adults living with human immunodeficiency virus/acquired immunodeficiency syndrome.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  Cross-sectional descriptive study.
  
  
  METHODS
  HIV clinics and community sites in the San Francisco Bay area.
  
  
  METHODS
  A convenience sample of 289 adults (193 men, 73 women, and 23 transgender) living with HIV/AIDS.
  
  
  METHODS
  None.
  
  
  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.
authors.affiliation: Department of Family Health Care Nursing, University of California at San Francisco, San Francisco, CA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
authors.affiliation: Department of Family Health Care Nursing, University of California at San Francisco, San Francisco, CA ; Lovisenberg Diakonale Hospital, Oslo, Norway ; Lovisenberg Diakonale University College, Oslo, Norway.
authors.forename: Caryl
authors.initials: C
authors.lastname: Gay
authors.affiliation: Department of Physiological Nursing, University of California at San Francisco, San Francisco, CA ; Cardiovascular Research Institute, University of California at San Francisco, San Francisco, CA.
authors.forename: Clive R
authors.initials: CR
authors.lastname: Pullinger
authors.affiliation: Department of Women, Children, and Family Health Sciences, University of Illinois at Chicago, Chicago, IL.
authors.forename: Mary Dawn
authors.initials: MD
authors.lastname: Hennessy
authors.affiliation: Sleep Disorders Center, University of California at San Francisco, San Francisco, CA.
authors.forename: Rochelle S
authors.initials: RS
authors.lastname: Zak
authors.affiliation: Department of Physiological Nursing, University of California at San Francisco, San Francisco, CA ; Institute for Human Genetics, University of California at San Francisco, San Francisco, CA.
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000235:genetics; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood / Q000235:genetics*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000235:genetics*; D006801:Humans; D007378:Interleukins / Q000097:blood / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D012495:San Francisco; D012890:Sleep / Q000235:genetics; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000235:genetics* / Q000503:physiopathology; D063106:Transgender Persons; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000235:genetics; D014851:Wakefulness / Q000235:genetics; D055815:Young Adult
chemical_list: D016207:Cytokines; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha
keywords: Actigraphy; HIV; cytokine; genetic; inflammation; sleep maintenance