Determinants of insufficient sleep among blacks and effects on disparities in health outcomes

项目摘要 睡眠不足(IS)，源于睡眠呼吸暂停、轮班工作、失眠、每周工作40小时以上、 不良的睡眠环境和/或自愿减少就寝时间，与患高血压的风险增加有关。 心血管疾病(CVD)标记物(高血压、胰岛素抵抗、血脂异常和 动脉僵硬)、炎症标志物(白介素6、肿瘤坏死因子-α和C反应蛋白)作为 以及脑部损伤。令人信服的证据表明，在睡眠不足(IS)方面存在种族/民族差异， 黑人患IS的风险是白人的三倍。差异可能由生理原因引起 和遗传因素，但最近的证据表明，环境和心理社会因素也是关键 决定因素。这项研究将利用多层次框架中的创新动态建模来描绘 心理社会和环境决定因素(关联因素)及其推定 与黑人不良健康后果的关系。个人级别和上下文级数据将是 使用新的基于家庭的记录和地理信息系统数据捕获，以模拟睡眠的环境背景 发生。这项拟议的研究将利用Jean博士领导的纽约大学睡眠差异工作组的成功- Louis(Pi)，他从事社区参与的睡眠研究已有10多年。工作组 由在睡眠和昼夜节律、心血管疾病、大脑健康、健康方面拥有专长的杰出研究人员组成 差异、转化行为医学和多层次动态建模。这项研究将受益于 我们常设社区指导委员会的经验，使560名黑人能够在不同的地方招募 参加为期一周的家庭学习的场所，以实现拟议的学习目标。多学科团队 意愿：1)确定心理社会(社会支持、歧视和态度/信仰)和环境 (家庭[密度、噪音、光线和温度]、社会经济地位、社会资本和 邻近[建成环境])与IS相关的因素；确定IS对(A)标记的影响 心血管疾病(肥胖、血压、血脂和血糖/糖化血红蛋白)和炎症(IL-6、IL-10和肿瘤坏死因子-α)等 (B)脑损伤的标志物(tau、淀粉样蛋白-β、神经丝光、同型半胱氨酸和胶质纤维酸性 蛋白质；并使用个人和个人开发具有IS相关不良健康后果的黑人的概况 应用创新的多层次动态建模工具(贝叶斯信念网络)的环境层次数据 和基于代理的仿真)。这项研究将为描述更高利率背后的因素提供证据 并解释了可能与心血管疾病、炎症和脑损伤的标记物之间的联系。 这些数据将为评估IS对这些小说的因果影响的纵向研究提供基础 减轻IS对健康结果不利影响的标志和干预措施。

Project Summary Insufficient sleep (IS), stemming from sleep apnea, shift work, insomnia, working over 40 hr./week, unfavorable sleep environments and/or volitional reduction of bedtime, is associated with increased risk of cardiovascular disease (CVD) markers (elevated blood pressure, insulin resistance, dyslipidemia and arterial stiffness), inflammatory markers (interleukin-6, tumor necrosis factor-α, and C-reactive protein) as well as with brain injury. Compelling evidence shows racial/ethnic disparities in insufficient sleep (IS), with blacks exhibiting a three-fold greater risk of IS relative to whites. Disparities might arise from physiologic and genetic factors, but recent evidence suggests environmental and psychosocial factors are also critical determinants. This study will utilize innovative dynamic modeling in a multi-level framework to delineate the psychosocial and environmental determinants (associative factors) of actigraphic IS and its putative associations with adverse health outcomes among blacks. Individual- and contextual-level data will be captured using novel home-based recordings and GIS data to model the environmental context where sleep occurs. The proposed study will leverage success of the NYU Sleep Disparity Workgroup led by Dr. Jean- Louis (PI), who has been conducting community-engaged sleep research for over 10 years. The workgroup comprises outstanding investigators with expertise in sleep and circadian rhythm, CVD, brain health, health disparities, translational behavioral medicine, and multi-level dynamic modeling. The study will benefit from experience of our standing Community Steering Committee, enabling recruitment of 560 blacks in various venues to participate in weeklong home studies to achieve proposed study aims. The multidisciplinary team will: 1) identify psychosocial (social support, discrimination, and attitudes/beliefs) and environmental (household [density, noise, light, and temperature], socioeconomic position, social capital, and neighborhood [built environment]) factors that are associated with IS; ascertain effects of IS on (a) markers of CVD (obesity, BP, lipid profile, and glucose/ HbA1C) and inflammation (IL-6, IL-10, and TNF-α) and on (b) markers of brain injury (tau, amyloid-β, neurofilament light, homocysteine, and glial fibrillary acidic protein; and develop profiles of blacks with IS-related adverse health outcomes using individual- and environmental-level data applying innovative multi-level dynamic modeling tools (Bayesia Belief Network and Agent-Based Simulation). This study will provide evidence to delineate factors underlying greater rates of IS among blacks and explain putative associations with markers of CVD, inflammation, and brain injury. These data will provide the foundation for longitudinal studies assessing causal effects of IS on these novel markers and interventions to mitigate adverse effects of IS on health outcomes.