Biomarkers of stress, allergy status, and structural changes of the airway and relations with sleep and asthma outcomes in urban children

城市儿童压力、过敏状态和气道结构变化的生物标志物以及与睡眠和哮喘结果的关系

• 批准号: 10392553
• 负责人: Mary A Carskadon
• 金额: $ 15.43万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-24 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10392553
• 关键词: 9 year old; Address; Affect; African American; Age; Allergens; Allergic; Area; Arousal; Asthma; Beds; Behavior; Behavioral; Belief; Biological; Biological Markers; Biological Response Modifiers; Caregivers; Child; Childhood; Cilia; Clinical; Corticotropin; Defect; Discrimination; Enrollment; Ethnic group; Exposure to; Faculty; Family; Functional disorder; Future; Goals; Home; Hypersensitivity; Immune; Immunologic Markers; Interferons; Interleukin-1 beta; Interleukin-13; Interleukin-4; Interleukin-5; Interleukins; Intervention; Interview; Irritants; Latino; Length; Light; Link; Location; Maintenance; Measurement; Measures; Melatonin; Methods; Minority; Monitor; Morbidity - disease rate; Neighborhoods; Nocturnal Asthma; Nose; Outcome; Parents; Patient Self-Report; Peak Expiratory Flow Rate; Pharmaceutical Preparations; Phase; Phenotype; Polysomnography; Population; Protocols documentation; Pulmonary Function Test/Forced Expiratory Volume 1; Reporting; Research; Research Infrastructure; Research Training; Resources; Risk; Role; Saliva; Sampling; Severities; Sleep; Spirometry; Stress; Structural defect; Structure; Structure of respiratory epithelium; Symptoms; Time; Variant; Walking; Work; Youth; actigraphy; base; career; circadian; common symptom; comorbidity; disorder control; ethnic difference; ethnic minority population; health disparity; high risk population; improved; minority children; neutrophil; novel; parent grant; peer; poor sleep; primary caregiver; programs; pulmonary function; skills; sleep behavior; sleep health; sleep pattern; sleep quality; stressor; telomere; treatment response; urban children; urban minority; urban poverty; urban setting

Project Summary / Abstract Pediatric health disparities in the areas of asthma and sleep persist; asthma and poor sleep outcomes are prevalent among ethnic minority and urban children. Known stressors of urban poverty and poorly controlled asthma can adversely impact the sleep health of urban children with asthma. Our work with urban children with persistent asthma has shown that Latino and African American (AA) children are exposed to sociocontextual (e.g., neighborhood stress, allergens/irritants) and cultural (e.g., acculturative stress) risks that challenge asthma management and increase asthma morbidity. Further, our recently completed study indicates real-time links among asthma, sleep quality, and daytime functioning in urban children. The roles of sleep context, daily sleep routines, and sleep behaviors of urban children of specific ethnic groups are unknown. Our work has focused on contributors to asthma health disparities, assessing sleep quality in this group with actigraphy and self-report sleep behavior measures. Cultural, sleep, and asthma-specific factors in children's sleep contexts can affect children's maintenance of healthy sleep behaviors, and in turn, asthma morbidity. Sleep timing and circadian measures have not been assessed in these groups. Targeting the sleep setting and sleep behaviors along with biological measures of underlying circadian timing in urban children with asthma has the potential to identify mechanisms to inform interventions to improve sleep and asthma outcomes. We propose to utilize a multi-method, in-depth approach to characterize the sleep patterns and sleep settings of urban children in combination with biological measures that may differ based on children's ethnic group background and may contribute to asthma outcomes. We will enroll 240 urban children (ages 7-9, from Latino, AA, and Non-Latino White backgrounds) with persistent asthma and their primary caregivers. Each child/caregiver will participate in a 16- day protocol involving an assessment of the child's sleep context, sleep status (by actigraphy; ambulatory polysomnography, PSG; saliva for dim light melatonin onset, DLMO), and asthma status (lung function by home spirometry, immune biomarker assessment, report of symptoms/control). The sleep context will be examined through our environmental walk-through assessment, in-depth caregiver/child interviews, and self-report assessments, and objective measurement of light during monitoring. The first aim of the study is to examine ethnic differences in sleep patterns, with a focus on such outcomes as timing (e.g., night-to-night variability in time to bed), continuity (e.g., nighttime arousals), and length (sleep duration) measured across 16 days with actigraphy, as well as circadian phase (DLMO) and alignment of sleep timing to circadian phase. The second aim involves examining ethnic differences in the co- occurrence of sleep status and asthma status. The third aim will identify sleep-related (e.g., sleep disruptors), asthma (e.g., availability/location of rescue medication), and cultural-related (e.g., sleep beliefs) risk and resource factors of children's sleep context that moderate associations between sleep and asthma outcomes.

项目总结/摘要 儿童在哮喘和睡眠方面的健康差异仍然存在;哮喘和睡眠不良的结果是 在少数民族和城市儿童中普遍存在。已知的城市贫困压力源和控制不力 哮喘会对城市哮喘儿童的睡眠健康产生不利影响。我们对城市儿童的工作， 持续性哮喘表明，拉丁裔和非洲裔美国人（AA）儿童暴露于社会背景， (e.g.,邻里压力，过敏原/刺激物）和文化（例如，文化适应压力）的风险，挑战 哮喘管理和增加哮喘发病率。此外，我们最近完成的研究表明， 城市儿童哮喘、睡眠质量和日间功能之间的联系睡眠环境的作用，每天 睡眠规律和特定民族的城市儿童的睡眠行为是未知的。我们的工作 重点关注哮喘健康差异的贡献者，用活动记录仪评估这组人的睡眠质量， 自我报告睡眠行为测量。儿童睡眠环境中的文化、睡眠和哮喘特异性因素 会影响儿童健康睡眠行为的维持，进而影响哮喘发病率。睡眠时间和 在这些群体中尚未评估昼夜节律措施。针对睡眠环境和睡眠行为 沿着对城市哮喘儿童生理节律的生物学测量， 确定为改善睡眠和哮喘结果的干预提供信息的机制。 我们建议利用多方法，深入的方法来表征睡眠模式和睡眠 结合可能因儿童种族而异的生物措施， 组背景，并可能有助于哮喘的结果。我们将招募240名城市儿童（7-9岁， 拉丁裔、AA和非拉丁裔白色背景），患有持续性哮喘及其主要照顾者。每个 儿童/护理人员将参加一项为期16天的方案，包括评估儿童的睡眠环境、睡眠状况、睡眠质量和睡眠质量。 状态（通过体动记录仪;动态多导睡眠图，PSG;唾液用于暗光褪黑激素起效，DLMO），以及 哮喘状态（通过家庭肺量计测定的肺功能、免疫生物标志物评估、症状/控制报告）。 睡眠环境将通过我们的环境步行评估进行深入研究， 看护者/儿童访谈，自我报告评估，以及监测期间的光的客观测量。 这项研究的第一个目的是研究睡眠模式的种族差异，重点是 作为时间的结果（例如，上床时间的夜间变化性），连续性（例如，夜间觉醒），以及 使用体动记录仪在16天内测量的长度（睡眠持续时间），以及昼夜节律相位（DLMO）， 睡眠时间与昼夜节律相一致。第二个目标是研究共同体中的种族差异， 睡眠状态和哮喘状态的发生。第三个目标是识别睡眠相关的（例如，睡眠干扰物）， 哮喘（例如，急救药物的可用性/位置），以及文化相关（例如，睡眠信念）风险和 儿童睡眠环境的资源因素，调节睡眠和哮喘结果之间的关联。