Circadian and sleep mechanisms among racial groups for nicotine dependence, craving, and withdrawal

项目总结 世界上头号可预防的死亡原因是烟草使用。尤其是吸烟，要付出代价 估计有3000亿美元是由于与医疗保健和生产力损失相关的费用。尽管有相似的吸烟 在吸烟率方面，与白人相比，黑人遭受与吸烟相关的伤害的比例更大。沉睡 差异，如睡眠时间缩短，昼夜节律周期更短，更早的时型，以及 据报道，与白人相比，黑人睡眠时间的变化更频繁。考虑到那可怜的人 睡眠质量预测戒烟计划的复发，特别是在社会经济学中 处于不利地位的成年人、睡眠不足和睡眠时间不规律可能会影响吸烟和 24小时内的戒断症状。令人惊讶的是，很少有研究研究这些 吸烟和渴求的时间模式，与睡眠障碍、时型或种族无关 差距。对这些因素的更好理解可能会解释吸烟人群的异质性， 尤其是在少数族裔中。因此，这项提议的目的是检验核心假设，即 吸烟的时型和睡眠受损，以及吸烟依赖、冲动/渴望和戒烟 取决于种族。三个具体目标将决定：睡眠时间和睡眠质量和数量的贡献 吸烟状况的种族差异(目标1)、客观睡眠特征和吸烟行为 吸烟的黑人和白人(目标2)，以及限制睡眠是否会改变渴望和戒断 针对不同种族的吸烟者(目标3)。具体地说，我们将利用自我报告问卷，客观衡量 睡眠质量和时间(活动记录)和昼夜节律(暗淡的褪黑素开始)，以及生态 对香烟使用、吸烟冲动、渴望和戒断症状的瞬时评估，以确定昼夜节律 和睡眠特征，这些特征与吸烟状况、吸烟的沉重程度和 黑人和白人之间的依赖。最后，我们将测试急性睡眠限制(4小时- 与延长睡眠时间(在床上10小时)相比，以下两种情况下的渴求和戒断症状会有所改善 在黑人和白人吸烟者中戒烟。如果成功，这项研究的结果将导致昼夜节律的识别 睡眠障碍和睡眠不足是睡眠和吸烟之间联系的基础机制 不同人群的吸烟行为和吸烟依赖。此外，这些发现可能会让人们 临床医生强调睡眠和睡眠时间对吸烟行为和吸烟依赖的重要性 帮助制定新的干预措施，以减少烟草使用造成的发病率和死亡率。

PROJECT SUMMARY The number one preventable cause of death in the world is tobacco use. Cigarette smoking in particular, costs an estimated $300 billion due to expenses related to medical care and lost productivity. Despite similar smoking prevalence rates, Blacks suffer disproportionately from smoking-related harms compared to Whites. Sleep disparities such as shortened sleep duration, shorter circadian periodicity, earlier chronotype, and increased variability of sleep timing have been reported more frequently in Blacks compared to Whites. Given that poor sleep quality predicts relapse from smoking cessation programs, particularly among socioeconomically disadvantaged adults, sleep deficiencies and irregular timing of sleep may impact smoking craving and withdrawal symptoms over the course of the 24-hour day. Surprisingly, few studies have examined these temporal patterns of smoking and craving, and none with regard to sleep disruption, chronotype or racial disparities. A better understanding of these factors may explain heterogeneity within the smoking population, especially in minorities. Thus, the purpose of this proposal is to test the central hypothesis that the impact of chronotype and impaired sleep on cigarette usage as well as smoking dependence, urge/craving, and withdrawal depends on race. Three specific aims will determine: contributions of sleep timing and sleep quality and quantity to racial disparities in smoking status (Aim 1), objective sleep characteristics and smoking behavior among blacks and whites who smoke cigarettes (Aim 2), and whether sleep restriction modifies craving and withdrawal in racially diverse smokers (Aim 3). Specifically, we will utilize self-report questionnaires, objective measures of sleep quality and timing (actigraphy) and circadian phase (dim light melatonin onset), as well as ecological momentary assessment of cigarette use, smoking urges, cravings, and withdrawal symptoms to identify circadian and sleep characteristics that are most strongly associated with smoking status, heaviness of smoking and dependence among blacks and whites. Finally, we will test whether acute sleep restriction (4 hours of time-in- bed) versus sleep extension (10 hours of time-in-bed) modifies craving and withdrawal symptoms following cessation in black and white smokers. If successful, the results of this study will result in identification of circadian dysfunction and insufficient sleep as mechanisms that underlie the association between sleep and cigarette smoking behaviors and dependence in diverse populations. Moreover, these findings are likely to inform clinicians of the importance of sleep and sleep timing on cigarette smoking behaviors and dependence that will help in the development of novel interventions to reduce morbidity and mortality caused by tobacco use.