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

项目摘要 睡眠不足（IS），由睡眠呼吸暂停、轮班工作、失眠、工作超过40小时引起。星期， 不良的睡眠环境和/或睡前时间的自愿减少与以下风险增加有关： 心血管疾病（CVD）标志物（血压升高、胰岛素抵抗、血脂异常和 动脉硬化）、炎症标志物（白细胞介素-6、肿瘤坏死因子-α和C反应蛋白）， 以及脑损伤。令人信服的证据显示，睡眠不足（IS）的种族/民族差异， 黑人患IS的风险是白人的三倍。差异可能来自生理学 和遗传因素，但最近的证据表明，环境和社会心理因素也很重要 决定因素本研究将利用创新的动态建模在一个多层次的框架，以描绘 活动记录IS的社会心理和环境决定因素（相关因素）及其假定的 与黑人不良健康结果的关系。个人和背景层面的数据将 使用新颖的基于家庭的记录和GIS数据来模拟睡眠的环境背景， 发生。这项拟议中的研究将利用由Jean博士领导的纽约大学睡眠差异工作组的成功， 路易斯（PI），谁一直在进行社区参与睡眠研究超过10年。的工作组 包括在睡眠和昼夜节律，心血管疾病，大脑健康，健康 差异，转化行为医学和多层次动态建模。这项研究将受益于 我们的常设社区指导委员会的经验，使560名黑人在各种招聘 场地参加为期一周的家居研习，以达致建议的研习目标。多学科小组 将：1）确定社会心理（社会支持，歧视和态度/信仰）和环境 （住户[密度、噪音、光线和温度]、社会经济地位、社会资本和 邻里[建筑环境]）与IS相关的因素;确定IS对（a）标记的影响 CVD（肥胖、BP、血脂和葡萄糖/HbA 1C）和炎症（IL-6、IL-10和TNF-α）以及 (b)脑损伤的标志物（tau蛋白、淀粉样蛋白-β、神经丝光、同型半胱氨酸和胶质细胞酸性蛋白） 蛋白质;并使用个体和 环境级数据，采用创新的多层次动态建模工具（Bayesia信念网络 基于Agent的仿真（Simulation）。这项研究将提供证据，以描绘因素的基础上更高的利率 并解释了与CVD、炎症和脑损伤标志物的推定关联。 这些数据将为纵向研究提供基础，评估IS对这些新的 标志物和干预措施，以减轻IS对健康结果的不利影响。

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.