The Health and Behavioral Effects of Sleep Deprivation Among the Urban Poor in India

项目总结/摘要 有证据表明，睡眠不足会导致认知功能受损， 健康受损（例如免疫和心血管功能改变）。然而，这些结论主要来自于 相关性关系或在睡眠实验室中持续几天的急性睡眠剥夺研究。此外，本发明还 关于弱势群体的睡眠和睡眠差异的研究有限，尽管环境恶劣， 穷人的睡眠问题。此外，睡眠不好与睡眠质量之间的潜在双向关系 而决策不善，可能是收入-健康梯度的一个调节因素，在很大程度上仍未得到探讨。在 简而言之，我们知道，睡眠不足可能是健康差距和加速衰老的重要因素， 关于低社会经济地位人群睡眠剥夺的原因和影响以及如何解决 这种差距在"现实世界"环境中尤其严重，时间跨度很长。 此K01应用程序将提供职业发展的关键培训，并开始缩小这一知识差距。 为了实现这一目标，一项有400名参与者的随机田间实验，每个参与者参加了一个以上的实验。 月，在印度金奈，将（1）客观地测量睡眠和关键环境因素，以提供 关于城市环境中睡眠剥夺的环境原因作用的初步证据，（2） 严格评估两种简单的可扩展干预措施，以减少低收入成年人的睡眠剥夺， 他们的自然环境，（3）估计改善睡眠对认知功能，决策， 制造，健康结果和行为（例如血压，饮酒）和收入，以及（4） 利用RCT参与者和50，000人的全国代表提出的关于睡眠的问题， 样本，估计睡眠剥夺的程度及其在印度城市更广泛的影响。 支持研究目标的培训目标和申请人的长期研究目标是扩大 知识和技能：（1）认知心理学和认知功能的测量，（2）衰老，和（3） 机器学习和预测建模。这种培训通过多种途径完成，包括 课程，指导性学习和导师制，将直接促进拟议的研究，并扩大范围 和申请人的长期研究生涯的影响，研究健康的差异和相互作用之间 健康和决策，这可能会影响认知和身体健康的个人年龄。 值得注意的是，虽然这个应用程序的重点是睡眠剥夺的影响， 决策范围更广。经常接触与贫穷有关的健康不良的其他方面， 例如疼痛，也有可能产生精神负担，导致认知受损和决策失误。 这些因素和决策之间的这种负反馈循环有可能进一步加剧 加剧了健康差距。这一想法的深远适用性超出了本提案的直接范围 通过各种渠道打开了具有高度公共卫生意义的大门。

Project Summary/Abstract Evidence demonstrates that sleep deprivation causes impaired cognitive function and is associated with impaired health (e.g. altered immune and cardiovascular function). Yet these conclusions largely derive from correlational relationships or studies of acute sleep deprivation lasting only a few days in sleep labs. Further, research on sleep in disadvantaged populations and sleep disparities is limited, despite severe environmental challenges to sleep among the poor. Moreover, the potentially bi-directional relationship between poor sleep and poor decision-making, a possible mediator of the income-health gradient, remains largely unexplored. In short, while poor sleep could be an important contributor to health disparities and accelerated aging, we know relatively little about the causes and impacts of sleep deprivation in low SES populations and how to address these disparities, a gap that is especially acute in “real-world” settings with extended time frames. This K01 application will provide key training for career advancement and begin to close this gap in knowledge. To accomplish this goal, a randomized field experiment with 400 participants, each enrolled for over one month, in Chennai, India, will (1) objectively measure sleep and key environmental factors to provide preliminary evidence on the role of environmental causes of sleep deprivation in an urban environment, (2) rigorously evaluate two simple scalable interventions to reduce sleep deprivation among low-income adults in their natural environments, (3) estimate the causal effect of improved sleep on cognitive function, decision- making, health outcomes and behaviors (e.g. blood pressure, alcohol consumption), and earnings, and (4) utilizing questions regarding sleep asked of both RCT participants and a 50,000 person nationally-representative sample, estimate the extent of sleep deprivation and its impacts more broadly in urban India. The training aims underpinning the research aims and the applicant's long-term research goals are to expand knowledge and skills in: (1) cognitive psychology and the measurement of cognitive function, (2) aging, and (3) machine learning and predictive modeling. This training, accomplished through multiple avenues including coursework, directed study, and mentorship, will directly facilitate the proposed research and extend the scope and impact of the applicant's long-term research career studying health disparities and interactions between health and decision-making which may impact both cognitive and physical health as individuals age. Notably, while this application focuses on the impacts of sleep deprivation, the potential for health to shape decision-making is much broader. Constant exposure to other aspects of poor health associated with poverty, such as pain, also have the potential to exert a mental tax, leading to impaired cognition and poor decisions. Such a negative feedback loop between these factors and decision-making has the potential to further exacerbate health disparities. The far-reaching applicability of this idea beyond the direct scope of this proposal opens the door to high public-health significance through a wide variety of channels.