Parental Problem Drinking and Child Sleep: Family and Physiological Mechanisms of

描述（由申请人提供）：酒精问题在普通人群中普遍存在，目前估计有1880万美国人患有酒精依赖或滥用（www.samhsa.gov），四分之一的美国儿童在其家庭中暴露于饮酒问题（Grant, 2000）。对孩子的影响可能很严重，包括情绪和行为问题，但实际上没有关于父母问题饮酒（PPD）对孩子睡眠影响的研究。睡眠对健康发育和适应性日间功能至关重要，但20%至40%的儿童临床上存在明显的睡眠中断。当前研究的目的是在探索性和多学科的框架内解决这些关于产后抑郁症和儿童睡眠之间关系的开放性科学问题。具体而言，目标是：(1)检查母亲和父亲PPD作为儿童睡眠时间较短、睡眠质量较低和睡眠时间表不稳定的危险因素；(2)考虑婚姻冲突和父母教养是PPD与儿童睡眠关联的潜在中介；(3)测试迷走神经功能（张力和戒断）是否调节PPD（及其相关的家庭功能障碍）与儿童睡眠问题之间的关联。这项研究将包括250名6至11岁的儿童及其已婚或同居父母；儿童将正常发展，并从更广泛的社区中汲取。儿童的睡眠将在一周内通过日记报告和活动记录仪进行评估。PPD、婚姻功能和亲子关系将使用多种测量方法和报告来测量，包括饮酒和冲突行为的附带报告，允许对关键结构进行无偏见的评估。完善的程序将评估迷走神经张力和撤退对实验室程序的反应。一些潜在的重要协变量也将被评估并包括在分析中，如父母抑郁、父母反社会行为和儿童适应问题。还将探讨基于父母和子女性别的关系差异。拟议的研究将促进对与产后抑郁症相关的儿童结局的理解，并通过提供第一个已知的产后抑郁症与儿童睡眠量、质量或时间安排之间关系的检查，为证明家庭压力对儿童睡眠的负面影响（PA-07- 140，睡眠和睡眠障碍研究）的少量但不断增长的文献做出贡献。此外，拟议的研究将在人际关系和生理水平上检查可能的风险机制（PA-07-046，身心相互作用和健康研究），为PPD和儿童睡眠之间的关联过程提供初步证据，并确定那些在PPD背景下可能面临最大睡眠问题风险的儿童。研究结果将为更有针对性的R01研究提供初步支持，并最终阐明干预或预防PPD和儿童睡眠问题等严重公共卫生问题的潜在目标。

DESCRIPTION (provided by applicant): Alcohol problems are prevalent in the general population, with an estimated 18.8 million Americans currently suffering from alcohol dependence or abuse (www.samhsa.gov) and 1 in 4 American children exposed to problem drinking in their family (Grant, 2000). The consequences for children can be serious, including emotional and behavioral problems, but has been virtually no examination of the impact of parental problem drinking (PPD) on child sleep. Sleep is critical for healthy development and adaptive daytime functioning, yet 20% to 40% of children experience clinically significant sleep disruptions. The objectives of the current study are to address these open scientific questions regarding the relation between PPD and child sleep within an exploratory and multidisciplinary framework. Specifically, the goals are to (1) examine maternal and paternal PPD as a risk factor for children's shorter sleep duration, lower sleep quality, and erratic sleep schedule; (2) consider marital conflict and parenting as potential mediators of the association between PPD and child sleep; and (3) test whether vagal functioning (tone and withdrawal) moderates the association between PPD (and associated family dysfunction) and child sleep problems. The study will include 250 children aged 6 to 11 and their married or cohabiting parents; children will be normally developing and drawn from the broader community. Children's sleep will be assessed over the course of one week using diary reports and actigraphy. PPD, marital functioning, and parent-child relations will be measured using multiple measures and reporters, including collateral reports of drinking and conflict behavior, permitting bias-free assessments of key constructs. Well-established procedures will assess vagal tone and withdrawal in response to laboratory procedures. A number of potentially important covariates will also be assessed and included in analyses, such as parental depression, parental antisocial behavior, and child adjustment problems. Differences in relations based on parent and child gender will also be explored. The proposed study will advance understanding of child outcomes associated with PPD and contribute to the small but growing literature that demonstrates the negative effects of family stress on child sleep (PA-07- 140, Research on Sleep and Sleep Disorders) by providing the first known examination of relations between PPD and child sleep amount, quality, or schedule. Further, the proposed study will examine possible mechanisms of risk at both the interpersonal and physiological levels (PA-07-046, Research on Mind-Body Interactions and Health), providing initial evidence for processes accounting for the associations between PPD and child sleep, and identifying those children who may be at greatest risk for sleep problems in the context of PPD. Findings will provide preliminary support for more focused R01 studies, and ultimately will shed light on potential targets for intervention or prevention addressing the serious public health concerns of PPD and child sleep problems. PUBLIC HEALTH RELEVANCE: Alcohol problems are a serious public health concern, yet their impact on family and child functioning are understudied. The proposed study is the first known examination between parental problem drinking (PPD) and child sleep parameters. Sleep disturbances in American children are highly prevalent, and research increasingly demonstrates their harmful effects on child functioning. However, little is known about how family stress may impact child sleep. Further, research is needed to identify mechanisms of risk involved in these influences. The proposed study examines relations between maternal and paternal PPD and child sleep quality, amount, and schedule; it also tests family relationship problems (e.g., marital and parent-child conflict) and physiological stress response (e.g., vagal tone and withdrawal) as mechanisms of risk. Findings of the proposed study will illuminate specific forms of sleep disturbances that are associated with PPD, help identify children and families at greatest risk, and lay the foundation for a focused program of longitudinal research.