Obstructive Sleep Apnea Endotypes and Impact on Phenotypes of People Living With HIV

Overnight Visit #1. Subjects will arrive to the research sleep laboratory at approximately 7PM and undergo the following procedures:

1. Polysomnography: Monitoring for standard clinical polysomnography study will be applied to the subject, as follows: The subject will have EEG, EMG, EOG, and ECG electrodes, an adhesive body position sensor placed in standard locations. Pulse oximetry sensor will be attached either to a finger or ear lobe and secured by tape. The following parameters will be measured during sleep: electroencephalogram, eye movement, electrocardiogram, electromyogram, leg movement, snoring sounds, nasal pressure, and nasal-oral airflow by thermistor, respiratory effort and body position by piezo-electric bands of the thorax and abdomen or magnetometers, position sensors, and pulse oximetry. This equipment is standard for diagnostic polysomnography and should not be uncomfortable.

Once all of this equipment has been comfortably and securely fastened, the subject will be allowed to fall asleep and data recording will begin. Subjects will be asked to remain in the supine position as much as possible. All data will be acquired on a 1401 plus interface and Spike 2 software. The study will end at approximately 6 AM, at which time the monitoring equipment will be removed, and the subject will undergo a blood draw in this fasting state. 2. Phlebotomy: Venipuncture will be performed by a certified research staff or physician using standard techniques and appropriate blood borne pathogen precautions. Approximately 10-15 cc of blood will be drawn in the morning at wake into serum separator and EDTA tubes. Serum samples will be immediately processed to separate serum, which will be stored in darkness at -70 F to preserve until analysis can be conducted. EDTA tubes will be processed and refrigerated for use within 24 hours. Blood will also be collected to measure high sensitivity C Reactive Protein (hsCRP), insulin, glucose (to calculate HOMA-IR), cytokines such as IL-6 and TNF-alpha.119 The investigators will also store plasma for other potential markers, to explore other interactions, such as markers of liver disease like ALT and AST.

Subjects will then be able to go home. They will leave the actiwatch for the investigators. The investigators anticipate that Overnight Visit #1 will last 10 hours (most of which will be spent asleep).

If subjects are not found to have OSA, they will not continue with the study. (End of Aim #1)