HIVの痛みに対する不眠症の影響 (HIPPI)

Participants will test positive for HIV and Insomnia.

Structured Clinical Interview For DSM-5 Sleep Disorders-Revised (SCISD-R) - is a semi structured interview for diagnosing sleep disorders according to Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)

• DSM-5 睡眠障害の構造化臨床面接 - 改訂版 (SCISD-R)

Home Sleep Test (HST) will measure airflow (i.e., nasal pressure) using a nasal cannula and oxygen saturation to identify apnea and hypopnea and calculate an apnea hypopnea index (AHI; number of apnea and hypopnea per hour).

• ホームスリープテスト

All participants will undergo quantitative sensory testing for assessment of endogenous pain modulation using painful heat, mechanical, and cold stimuli in a laboratory session lasting approximately 1 hour.

Participants who have an HIV positive status will have blood tested for cluster of differentiation 4 (CD4) and Viral load to confirm positive status.

Participants will test positive for HIV and test negative for Insomnia.

Structured Clinical Interview For DSM-5 Sleep Disorders-Revised (SCISD-R) - is a semi structured interview for diagnosing sleep disorders according to Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)

• DSM-5 睡眠障害の構造化臨床面接 - 改訂版 (SCISD-R)

Home Sleep Test (HST) will measure airflow (i.e., nasal pressure) using a nasal cannula and oxygen saturation to identify apnea and hypopnea and calculate an apnea hypopnea index (AHI; number of apnea and hypopnea per hour).

• ホームスリープテスト

All participants will undergo quantitative sensory testing for assessment of endogenous pain modulation using painful heat, mechanical, and cold stimuli in a laboratory session lasting approximately 1 hour.

Participants who have an HIV positive status will have blood tested for cluster of differentiation 4 (CD4) and Viral load to confirm positive status.

Participants will test negative for HIV and test positive for Insomnia.

Structured Clinical Interview For DSM-5 Sleep Disorders-Revised (SCISD-R) - is a semi structured interview for diagnosing sleep disorders according to Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)

• DSM-5 睡眠障害の構造化臨床面接 - 改訂版 (SCISD-R)

Home Sleep Test (HST) will measure airflow (i.e., nasal pressure) using a nasal cannula and oxygen saturation to identify apnea and hypopnea and calculate an apnea hypopnea index (AHI; number of apnea and hypopnea per hour).

• ホームスリープテスト

All participants will undergo quantitative sensory testing for assessment of endogenous pain modulation using painful heat, mechanical, and cold stimuli in a laboratory session lasting approximately 1 hour.

Participants who have an HIV negative status will complete the OraQuick Advance Rapid HIV 1/2 Swab test to confirm negative status.

• オラクイック

Participants will test negative for HIV and test negative for Insomnia.

Structured Clinical Interview For DSM-5 Sleep Disorders-Revised (SCISD-R) - is a semi structured interview for diagnosing sleep disorders according to Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)

• DSM-5 睡眠障害の構造化臨床面接 - 改訂版 (SCISD-R)

Home Sleep Test (HST) will measure airflow (i.e., nasal pressure) using a nasal cannula and oxygen saturation to identify apnea and hypopnea and calculate an apnea hypopnea index (AHI; number of apnea and hypopnea per hour).

• ホームスリープテスト

All participants will undergo quantitative sensory testing for assessment of endogenous pain modulation using painful heat, mechanical, and cold stimuli in a laboratory session lasting approximately 1 hour.

Participants who have an HIV negative status will complete the OraQuick Advance Rapid HIV 1/2 Swab test to confirm negative status.

• オラクイック

TNF-a, IL-6, IL-12, IL-18, C-reactive protein, sCD14/163, D-dimer and IFN-gamma assays will be performed on the blood to identify levels of pro-inflammatory markers.

IFN-a, TGF-B, IL4, IL-10 and IL-13 assays will be performed on the blood to identify levels of anti-inflammatory markers.

Mitochondrial DNA damage, Damage associated molecular patterns (DAMPS) and Cortisol assays will be performed on the blood to identify levels of oxidative stress markers.

Pain threshold refers to the intensity at which a stimulus is first perceived as painful. Heat stimuli will be delivered using a computer-controlled thermal stimulation system with a 30 millimeter X 30 millimeter probe. From a baseline of 32 degrees Celsius, the probe temperature will increase at a rate of .5 degrees Celsius/second until the participant responds by pressing a button on a handheld device. For heat pain threshold, participants will be instructed to press the button when the sensation "first becomes painful"

Pain tolerance refers to the maximum amount of pain produced by a stimulus that a person is able/willing to tolerate. Heat stimuli will again be delivered using the computer-controlled thermal stimulation system. From a baseline of 32 degrees Celsius, the probe temperature will increase at a rate of .5 degrees Celsius/second until the participant responds by pressing a button on a handheld device. For heat pain tolerance, participants will be instructed to press the button when they are "no longer willing to tolerate" the painful sensation.

Mechanical temporal summation was assessed using a nylon Von Frey Filament (Stoelting Co., 6.65 g), which is calibrated to bend at 300 g of pressure. The filament was applied to the back of the non-dominant hand for approximately 1 second until the monofilament bent slightly. Participants were instructed to rate their pain level using the 0-100 Numeric Rating Scale (higher numbers represent greater pain). The filament was then applied to the skin for a series of 10 consecutive applications. Participants were instructed to rate the highest level of pain they experienced during the trial. This process was repeated for two trials (2 single trials, 2 series of 10). For each trial, a difference score was calculated between the series of 10 applications and the single presentation, which represented mechanical TS. The difference score was averaged across the two trials.

Temporal summation of pain refers to a form of endogenous pain facilitation characterized by the perception of increased pain despite constant or even reduced peripheral afferent input. Temporal summation is presumed to be the psychophysical manifestation of wind-up. Wind-up is a phenomenon where repetitive stimulation of C primary afferents at rates greater than 0.3 Hertz produces a slowly increasing response of second-order neurons in the spinal cord. A series of 5 heat pulses will be repeated every two seconds starting at a baseline temperature of 40 and participants will be asked to rate how painful each peak of the pulse feels to them using a pain rating of 0-100 numeric rating scale. Pain intensity was assessed using a 0-100 numeric rating scale, where 0 indicates no pain and 100 indicates the worst pain imaginable. Participants rated their pain intensity, with higher scores indicating greater pain severity. Temperatures included 44, 46, and 48 degrees in Celsius.

A cold-water bath (conditioning stimulus) was set to 10°C prior to the visit. Participants placed their non-dominant hand in the water bath up to their wrist for a maximum of 60 seconds. Immediately after withdrawal of the hand from the cold water, pressure was then applied to the dominant forearm or trapezius muscle using an algometer (testing stimulus). Participants were instructed to press a button when they first felt pain, resulting in termination of the stimuli. This procedure was repeated for a total of 4 trials (2 on each body site) and body site order was randomized (i.e., Forearm, Trapezius, Forearm, Trapezius, Forearm). An average pressure pain threshold score (kiloPascals - kPa of pressure) was generated across the two trials at each site after water immersion. Conditioned pain modulation was calculated as the difference score between baseline pressure pain threshold (kPa) and the average pressure pain threshold after water immersion at each body site

A light weight and compact watch-like device used for objective measurement of sleep. The device will be worn for 7 consecutive days/nights and will track physical activity, falling asleep and waking events, and includes an integrated light sensor for recording photopic light.

A sleep diary including daily questions will be filled out every day for seven days including questions about a participants nightly sleep experiences.

A caffeine dairy including different types of caffeine generally available for the participants to record their daily caffeine consumption of for seven days.

A light weight and compact watch-like device used for objective measurement of sleep. The device will be worn for 7 consecutive days/nights and will track physical activity, falling asleep and waking events, and includes an integrated light sensor for recording photopic light. The primary actigraphic sleep outcome presented here is sleep efficiency. Sleep efficiency will be assessed using wrist-worn actigraphy and calculated as the percentage of time spent asleep relative to the total time spent in bed during the designated sleep period. Sleep efficiency is derived by dividing total sleep time by time in bed and multiplying by 100. The mean scores presented here are percentages. Higher percentages indicate greater sleep efficiency.

The Short Physical Performance Battery consists of 3 individual sub-tests - standing balance (participants are asked to stand in 3 easy stances for 10 seconds), 4-meter gait speed (participants are asked to walk a steady pace in a straight line for 4-meters) and 5-repetition sit-to-stand (participants are asked to stand up and sit back down in a stable chair up to 5 times). All 3 are simple and quick to perform in the outpatient setting and require only limited equipment. The total short physical performance battery score ranges from 0-12, with higher scores indicating better physical performance.

The Timed Up and Go test (TUG) is a commonly used screening tool to assist clinicians to identify patients at risk of falling. Participants are asked to start in a sitting position in a chair, stand up and walk approximately 3 meters before turning to return to the chair at a steady, straight pace. The outcome will be measured with a stopwatch, then rating difficulty 0-100 (0 no difficulty and 100 being the most difficult imaginable) and pain 0-100 (0 no pain and 100 being the most pain imaginable).

The Munich Chronotype Questionnaire (MCTQ) estimates chronotype primarily from the midpoint of sleep on free days, called MSF (mid-sleep on free days), with MSFsc (sleep-corrected MSF) generally preferred because it adjusts for accumulated weekday sleep debt. The outcome reported in this trial is expressed in minutes - "mid-sleep time on free days, sleep-corrected (minutes). Higher values represent a later/evening chronotype, whereas lower values represent an earlier/morning chronotype.

The Insomnia severity index is a 7 item measure that has each participant subjectively measure their insomnia severity. Each is rated from 0 (none/not at all) to 4 (very severe/very much). The responses are summed to produce a total score that ranges from 0 to 28; higher scores suggest great subjective insomnia severity.

This questionnaire better helps the investigators understand how each participant's financial, racial, social, etc. background. It ranges from general questions such as age and birthday, to socioeconomic questions such as work status and financial stability.

The Center for Epidemiologic Studies Depression Scale (CES-D) is a 20-item self-report measure of depressive symptoms experienced during the past week, with each item scored 0-3 for a total of 0-60. Commonly used cutoffs are <16 = no significant depressive symptomatology, 16-26 = mild/moderate symptoms, and ≥27 = severe symptoms, although the CES-D is a screening measure rather than a diagnostic instrument. Higher scores indicate greater depressive symptom burden.

Sleep is a key aspect in an individual's everyday life. This questionnaire measures overall sleep quality in six different categories---Regularity, Sleep quality, alertness, timing, efficiency, and duration. This helps investigators understand a person's sleep efficacy.

The PHQ-15 (Patient Health Questionnaire-15) is a 15-item self-report measure of somatic symptom burden, with each symptom scored 0 (not bothered), 1 (bothered a little), or 2 (bothered a lot), producing a total score of 0-30. Commonly used severity categories are 0-4 = minimal, 5-9 = low, 10-14 = medium, and 15-30 = high somatic symptom severity.

The Difficulties in Emotion Regulation Scale (DERS) is a 36-item self-report measure assessing difficulties with emotion regulation across six domains, with items typically rated 1 (almost never) to 5 (almost always), yielding a total score of 36-180. Higher scores indicate greater emotion-regulation difficulties, and there are no universally accepted clinical cutoff scores; scores are generally interpreted relative to normative samples or as continuous measures of emotion-regulation difficulty.

The Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) assesses maladaptive beliefs and expectations about sleep; the commonly used DBAS-16 contains 16 items rated on a 0-10 scale, producing a mean score from 0-10. Higher scores indicate stronger dysfunctional sleep beliefs.

This questionnaire seeks to understand how pain has an influence/impacts an individual's everyday life and activities, sleep, and mood in general. Pain intensity and interference in everyday life was assessed using a 0-5 numeric rating scale, where 0 indicates no pain and 5 indicates the worst pain imaginable. Participants rated their pain intensity and interference, with higher scores indicating greater pain severity.

Dietary intake will be assessed using Sorge 24-hour Food Records. These records will be analyzed with the Nutrition Data System for Research (NDSR), a computer-based dietary assessment software developed by the Nutrition Coordinating Center at the University of Minnesota. Trained interviewers document all foods, beverages, and, when applicable, dietary supplements consumed during the preceding 24 hours. Information regarding food type, portion size, ingredients, preparation methods, and consumption occasions will be collected to improve the completeness and accuracy of dietary reporting. The reported dietary intake will be entered into NDSR and the resulting data may include total energy intake, macronutrients, micronutrients, and other dietary components. NDSR access is proprietary and requires a subscription. We did not have the funds to access NDSR and thus we do not have resulting data to present. The numbers below represent completed 24 hour food records for each group.

This questionnaire asks about a person's general diet and intake.

The DAST-10 (Drug Abuse Screening Test-10) is a 10-item self-report screening measure of drug-related problems, with each yes/no item scored 0 or 1, producing a total score of 0-10. Common interpretation is 0 = no problems, 1-2 = low level, 3-5 = moderate, 6-8 = substantial, and 9-10 = severe drug-related problems; it is a screening tool rather than a diagnostic measure.

The State-Trait Anxiety Inventory-Trait (STAI-T) is a 20-item self-report measure of relatively stable, enduring anxiety proneness, with each item rated 1-4, producing a total score of 20-80. Higher scores indicate greater trait anxiety, but there are no universally accepted clinical severity cutoffs; scores are generally interpreted relative to normative populations, with higher scores reflecting greater anxiety tendency.

The Penn State Cigarette Dependence Index (PSCDI) is a brief self-report measure of cigarette dependence, assessing factors such as smoking frequency, time to first cigarette, and difficulty refraining from smoking. The commonly used 9-item version produces a score of 0-9, with higher scores indicating greater nicotine dependence; there are no universally accepted clinical severity cutoffs, so scores are typically interpreted continuously or using study-specific thresholds.

The Penn State Electronic Cigarette Dependence Index (Penn State ECigarette Dependence Index; PS-ECDI) is a brief self-report measure of e-cigarette/vaping dependence, assessing features such as frequency of use, time to first use, and difficulty refraining. The 10-item version is scored from 0-20, with higher scores indicating greater e-cigarette dependence; commonly used categories are 0-3 = no dependence, 4-8 = low, 9-12 = moderate, 13-16 = high, and 17-20 = very high dependence.

The AUDIT-C (Alcohol Use Disorders Identification Test-Consumption) is a 3-item screening measure of alcohol consumption, with each item scored 0-4, producing a total score of 0-12. Higher scores indicate greater alcohol consumption and likelihood of hazardous drinking.

This questionnaire detects and measures substance abuse, alcohol, and smoking as well as related problems. It aims to detect the risky behavior related to each.

The 22-item PROMIS Anger scale is a self-report measure of anger and irritability, with each item typically rated from 1 (never) to 5 (always), yielding a raw score of 22-110. Higher raw scores indicate greater anger, but raw scores are not usually interpreted with fixed clinical severity cutoffs.

The Perceived Stress Scale (PSS) is a 10-item self-report measure assessing how unpredictable, uncontrollable, and overwhelming respondents have found their lives during the past month. Each item is scored 0-4, producing a total raw score of 0-40; higher scores indicate greater perceived stress, but there are no universally accepted clinical severity cutoffs, so scores are generally interpreted continuously.

The Pain Catastrophizing Scale (PCS) is a 13-item self-report measure assessing three aspects of pain catastrophizing: rumination, magnification, and helplessness. Each item is scored 0-4, producing a total raw score of 0-52; higher scores indicate greater pain catastrophizing, with ≥30 commonly used as a clinically relevant level of catastrophizing.

the HIV Stigma Mechanisms Scale (HIV-SMS) assesses three distinct dimensions of HIV-related stigma: enacted (promulgated) stigma, internalized stigma, and anticipated stigma. The original 24-item instrument uses separate five-point response scales for each dimension.

Scoring and interpretation

• Enacted stigma (9 items): Participants report how frequently they have experienced stigmatizing treatment because of their HIV status, using a five-point scale from 1 (never) to 5 (very often).
• Internalized stigma (6 items): Participants rate their agreement with statements reflecting negative feelings or beliefs about themselves because of their HIV status, using a five-point scale from 1 (strongly disagree) to 5 (strongly agree).
• Anticipated stigma (9 items): Participants rate how likely they believe others are to treat them in stigmatizing ways because of their HIV status, using a five-point scale from 1 (very unlikely) to 5 (very likely).

The Heightened Vigilance Scale is a 6-item self-report measure assessing the extent to which individuals feel they must remain alert and cautious because of the possibility of experiencing unfair treatment or discrimination. Each item is typically rated on a 1-6 scale, producing a total score of 6-36, with higher scores indicating greater perceived vigilance.

The 9-item Experiences of Discrimination (EOD) measure assesses lifetime experiences of discrimination across nine settings, including school, employment, housing, health care, and public settings. Each item is scored according to whether the participant reports experiencing discrimination in that setting. For a situation-based total score, responses are coded as 0 (no) or 1 (yes) and summed across the nine items, yielding a total score ranging from 0 to 9. Higher scores indicate experiences of discrimination across a greater number of settings and therefore represent a worse outcome.

The Adverse Childhood Experiences (ACE) Questionnaire is a 10-item retrospective self-report measure assessing exposure to potentially traumatic or stressful experiences before age 18, including abuse, neglect, and household dysfunction. Each experience is typically scored 0 (no) or 1 (yes), producing a total ACE score of 0-10, with higher scores indicating exposure to a greater number of adverse childhood experiences

The Lee Fatigue Scale (LFS) is an 18-item self-report measure assessing fatigue severity and energy level, with items rated on a 0-10 scale. Scores are typically averaged across items to produce a 0-10 overall fatigue score, with higher scores indicating greater fatigue