The Impact of Insomnia on Pain in HIV

NCT ID: NCT04298658

Last Updated: 2025-09-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

171 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-01-01

Study Completion Date

2025-07-31

Brief Summary

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The overall objective of this application is to investigate the impact of insomnia on pain, physical functioning, and inflammation in people living with HIV. The two aims of this study to determine 1) whether insomnia promotes increased sensitivity and inflammatory reactivity to pain stimuli, and 2) if weekly fluctuations in insomnia burden drive changes in inflammation, pain severity, and physical functioning in people living with HIV. This research could help confirm insomnia as a therapeutic target for the suppression of pain and inflammation in people living with HIV.

Detailed Description

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Experimental session 1 Resting Blood Pressure and Body Mass Index will be assessed. Participants who have an HIV negative status will complete the OraQuick Advance Rapid HIV 1/2 Swab test. Study staff will administer the Structured Interview for Sleep Disorders and administer the Rapid Estimation of Adult Literacy Measure-Short Form (REALM-SF) to determine health literacy. The night of Experimental Session 1 participant will be using a Resmed ApneaLink Air device (Resmed, San Diego, CA), to identify apnea and hypopnea and calculate an apnea hypopnea index.

Between Experimental Session 1 and Experimental Session 2 Sleep assessment: Sleep data will be collected by participants in their own homes using objective and subjective measures of their sleep. Participant instructions for how to collect and record their own sleep data will be provided at the end of study session 1. Participant will be provided with a watch-like device to wear on wrist for 7 consecutive days and nights. This watch measures physical activity and sleep.

Experimental Session 2 Resting Blood Pressure and temperature will be assessed. A sample of urine will be taken to test for illicit substances that might affect the study's results. Experimental session 2 will take place in the Center for Clinical and Translational Science (CCTS) Clinical Research Unit (CRU). A clinical Research Unit (CRU) nurse will place an intravenous (IV) cannula (small plastic tube) in the arm using a needle to draw blood at the beginning of the session and then an additional four times across the study for a total of five blood draws. Participants will complete multiple questionnaires to measure health, and experience with insomnia, pain, mood and emotions, experiences with stigma and discrimination, and how participant thinks and feels about things. 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 3-4 hours. Blood will be processed and stored and then used to measure inflammation.

Weekly Follow-up Sessions Participants will then complete a battery of ecologically valid movement tasks that include: 1) Performance Battery (SPPB) which includes sitting in a chair, transitioning to a standing position, balancing tests and gait speed, and the Timed Up and Go test (TUG). A clinical Research Unit (CRU) nurse will draw a quick sample of approximately 20 milliliters from the participants arm using a butterfly needle so that CRU nurse can collect blood during the beginning of each visit.

Conditions

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HIV Insomnia

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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HIV and Insomnia

Participants will test positive for HIV and Insomnia.

Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)sleep disorders-revised

Intervention Type DIAGNOSTIC_TEST

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)

Resmed ApneaLink Air device (Resmed, San Diego, CA).

Intervention Type DIAGNOSTIC_TEST

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).

Quantitative Sensory testing (QST)

Intervention Type OTHER

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.

Cluster of Differentiation 4 (CD4) and Viral load

Intervention Type DIAGNOSTIC_TEST

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

HIV Without Insomnia

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

Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)sleep disorders-revised

Intervention Type DIAGNOSTIC_TEST

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)

Resmed ApneaLink Air device (Resmed, San Diego, CA).

Intervention Type DIAGNOSTIC_TEST

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).

Quantitative Sensory testing (QST)

Intervention Type OTHER

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.

Cluster of Differentiation 4 (CD4) and Viral load

Intervention Type DIAGNOSTIC_TEST

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

Non HIV with Insomnia

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

Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)sleep disorders-revised

Intervention Type DIAGNOSTIC_TEST

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)

Resmed ApneaLink Air device (Resmed, San Diego, CA).

Intervention Type DIAGNOSTIC_TEST

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).

Quantitative Sensory testing (QST)

Intervention Type OTHER

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.

OraQuick Advance Rapid HIV 1/2 Swab test

Intervention Type DIAGNOSTIC_TEST

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

Non HIV Without Insomnia

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

Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)sleep disorders-revised

Intervention Type DIAGNOSTIC_TEST

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)

Resmed ApneaLink Air device (Resmed, San Diego, CA).

Intervention Type DIAGNOSTIC_TEST

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).

Quantitative Sensory testing (QST)

Intervention Type OTHER

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.

OraQuick Advance Rapid HIV 1/2 Swab test

Intervention Type DIAGNOSTIC_TEST

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

Interventions

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Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)sleep disorders-revised

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)

Intervention Type DIAGNOSTIC_TEST

Resmed ApneaLink Air device (Resmed, San Diego, CA).

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).

Intervention Type DIAGNOSTIC_TEST

Quantitative Sensory testing (QST)

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.

Intervention Type OTHER

OraQuick Advance Rapid HIV 1/2 Swab test

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

Intervention Type DIAGNOSTIC_TEST

Cluster of Differentiation 4 (CD4) and Viral load

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

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Structured Clinical Interview For DSM-5 Sleep Disorders-Revised (SCISD-R) Home Sleep Test OraQuick

Eligibility Criteria

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Inclusion Criteria

HIV with Insomnia

* Confirmed HIV diagnosis
* currently a patient in the University of Alabama (UAB) 1917 HIV Clinic.
* must be currently receiving stable antiretroviral therapy (ART).
* Meets the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) diagnostic criteria for insomnia including sleep difficulty.

HIV Without Insomnia

* Confirmed HIV diagnosis
* currently a patient in the University of Alabama (UAB) 1917 HIV Clinic.
* must be currently receiving stable antiretroviral therapy (ART).
* Does not meet the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) diagnostic criteria for insomnia including sleep difficulty.

Non HIV with Insomnia

* Confirmed Non HIV diagnosis and currently not a patient in the UAB 1917 HIV Clinic.
* Meets DSM-5 diagnostic criteria for insomnia including sleep difficulty.

Non HIV Without Insomnia

* Confirmed Non HIV diagnosis and currently not a patient in the UAB 1917 HIV Clinic.
* Does not meets DSM-5 diagnostic criteria for insomnia including sleep difficulty.

Exclusion Criteria

* concurrent medical conditions that could confound
* interpretation of sleep
* pain
* inflammatory issues or coexisting diseases
* Systemic rheumatic disease/condition
* uncontrolled hypertension (i.e., BP \> 150/95)
* circulatory disorders (e.g., Reynaud's disease)
* history of heart disease or cardiac events
* history of cancer
* asthma AND use of an inhaler
* history of seizures
* history of stroke or other neurological disorder
* pregnancy
* core body temperature \> 100 degrees Fahrenheit as this could indicate acute infection with fever; (k)
* unwilling to provide blood for this study
* non-English speaking
* recent injury or surgical procedure within past 6 months.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Burel Goodin

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Burel R Goodin, PHd

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Locations

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UAB

Birmingham, Alabama, United States

Site Status

Countries

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United States

References

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Tenorio AR, Zheng Y, Bosch RJ, Krishnan S, Rodriguez B, Hunt PW, Plants J, Seth A, Wilson CC, Deeks SG, Lederman MM, Landay AL. Soluble markers of inflammation and coagulation but not T-cell activation predict non-AIDS-defining morbid events during suppressive antiretroviral treatment. J Infect Dis. 2014 Oct 15;210(8):1248-59. doi: 10.1093/infdis/jiu254. Epub 2014 May 1.

Reference Type BACKGROUND
PMID: 24795473 (View on PubMed)

Goodin BR, Owens MA, Yessick LR, Rainey RL, Okunbor JI, White DM, Mushatt KA, Harmon OA, Heath SL, Merlin JS. Detectable Viral Load May Be Associated with Increased Pain Sensitivity in Persons Living with HIV: Preliminary Findings. Pain Med. 2017 Dec 1;18(12):2289-2295. doi: 10.1093/pm/pnx057.

Reference Type BACKGROUND
PMID: 28398572 (View on PubMed)

Merlin JS, Westfall AO, Heath SL, Goodin BR, Stewart JC, Sorge RE, Younger J. Brief Report: IL-1beta Levels Are Associated With Chronic Multisite Pain in People Living With HIV. J Acquir Immune Defic Syndr. 2017 Aug 1;75(4):e99-e103. doi: 10.1097/QAI.0000000000001377.

Reference Type BACKGROUND
PMID: 28328552 (View on PubMed)

Other Identifiers

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1R01HL147603-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

300003778

Identifier Type: -

Identifier Source: org_study_id

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