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

项目摘要/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于 睡眠实验室中只持续几天的急性睡眠剥夺的相关关系或研究。此外， 尽管环境恶劣，但对弱势群体的睡眠和睡眠差距的研究有限 在穷人中睡觉的挑战。此外，睡眠不佳之间潜在的双向关系 糟糕的决策是收入-健康梯度的一个可能的调解人，但在很大程度上仍未得到探索。在……里面 简而言之，尽管睡眠不佳可能是健康差距和加速衰老的重要因素，但我们知道 对低SES人群中睡眠剥夺的原因和影响以及如何解决的研究相对较少 这些差异，这一差距在时间框架延长的“现实世界”环境中尤为严重。 这款K01应用程序将为职业发展提供关键培训，并开始弥合这一知识差距。 为了实现这一目标，一项有400名参与者的随机现场试验，每个人都登记了一个以上的人 月，在印度金奈，将(1)客观测量睡眠和关键环境因素，以提供 城市环境中睡眠不足的环境原因作用的初步证据，(2) 严格评估两种减少低收入成年人睡眠剥夺的简单、可扩展的干预措施 他们的自然环境，(3)估计睡眠改善对认知功能的因果影响，决策- 制造、健康结果和行为(如血压、饮酒)和收入，以及(4) 利用向随机对照试验参与者和全国50,000人询问的有关睡眠的问题-代表 抽样，估计印度城市睡眠剥夺的程度及其更广泛的影响。 支持研究目标的培训目标和申请者的长期研究目标是扩展 知识和技能：(1)认知心理学和认知功能的测量，(2)衰老，(3) 机器学习和预测建模。这种培训是通过多种途径完成的，包括 课程作业、指导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健康差距和相互作用的影响 健康和决策，随着个人年龄的增长，可能会影响认知和身体健康。 值得注意的是，虽然这项应用关注的是睡眠不足的影响，但健康的潜在影响 决策的范围要广泛得多。经常暴露在与贫困相关的健康不良的其他方面， 例如疼痛，也有可能造成精神负担，导致认知受损和糟糕的决定。 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 通过各种渠道开启对公众健康具有高度重要性的大门。

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.