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

项目概要/摘要 有证据表明，睡眠不足会导致认知功能受损，并与 健康受损（例如免疫和心血管功能改变）。然而这些结论很大程度上源自 在睡眠实验室中仅持续几天的急性睡眠剥夺的相关关系或研究。此外， 尽管环境严峻，但对弱势群体睡眠和睡眠差异的研究仍然有限 穷人的睡眠面临挑战。此外，睡眠不佳之间存在潜在的双向关系。 糟糕的决策可能是收入与健康梯度的调节因素，但在很大程度上仍未得到探索。在 简而言之，虽然睡眠不足可能是导致健康差异和加速衰老的一个重要因素，但我们知道 关于低社会经济地位人群睡眠不足的原因和影响以及如何解决的问题相对较少 这些差异在时间框架较长的“现实世界”环境中尤其严重。 该 K01 应用程序将为职业发展提供关键培训，并开始缩小这一知识差距。 为了实现这一目标，我们进行了一项 400 名参与者的随机现场实验，每人参加了一项以上的研究 月，在印度钦奈，将 (1) 客观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的作用的初步证据，(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不足 他们的自然环境，（3）估计睡眠改善对认知功能、决策的因果影响 制作、健康结果和行为（例如血压、饮酒）和收入，以及 (4) 利用随机对照试验参与者和 50,000 名全国代表提出的有关睡眠的问题 样本，估计印度城市睡眠不足的程度及其更广泛的影响。 培训目标支持研究目标，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测量，(2) 衰老，以及 (3) 机器学习和预测建模。此次培训通过多种途径完成，包括 课程作业、定向学习和指导将直接促进拟议的研究并扩大范围 以及申请人长期研究生涯的影响，研究健康差异和之间的相互作用 随着个人年龄的增长，健康和决策可能会影响认知和身体健康。 值得注意的是，虽然该应用程序侧重于睡眠不足的影响，但塑造健康的潜力 决策的范围要广泛得多。持续暴露于与贫困相关的健康状况不佳的其他方面， 例如疼痛，也有可能产生精神负担，导致认知受损和做出错误的决定。 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 通过多种渠道打开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.