Sleep Patterns as a risk factor for disease in the Hispanic Community Health Stud

描述（由申请人提供）：随着电力和互联网等技术的进步，人类越来越多地生活在24小时社会中，这导致了睡眠模式的重大变化，包括在过去80年里，美国成年人的平均睡眠时间减少了2小时。初步研究表明，睡眠的改变，包括睡眠量、质量和规律性的降低，与心血管疾病（CVD）和心血管疾病危险因素（如肥胖、糖尿病和高血压）的风险增加多达3倍有关。因此，对睡眠的影响可能反映了21世纪生活方式易患心脏病的机制之一。然而，由于缺乏对睡眠的客观测量，现有的关于睡眠作用的文献在很大程度上受到了限制，而且没有包括少数民族的代表性样本，而少数民族的睡眠质量差的风险最大。在拟议的西班牙裔社区健康研究（HCHS）的辅助研究中，我们的目标是通过收集2000名研究参与者的睡眠模式的客观测量来填补这一空白，这些参与者已经接受了广泛的心血管疾病风险因素和结果的严格评估。利用HCHS资源和扩大评估，包括客观的睡眠模式测量，将提供独特和有效的机会：(1)评估西班牙裔美国人睡眠模式改变的普遍程度，并评估种族亚群之间的差异；(2)明确社会经济地位、家庭、工作环境和情绪等社会心理因素以及文化适应、家庭主义和睡眠信念等拉美裔美国人特有的文化因素在预测异常睡眠模式中的重要性；(3)评估西班牙裔美国人睡眠不良与相关心血管健康结局（包括肥胖、高血压、糖尿病和心脏病）之间的关系。提出的新数据和分析将有助于阐明睡眠障碍在心血管疾病发展中的作用，同时也为美国最大的少数群体中导致不良睡眠习惯的主要因素提供见解，从而建立一个框架，以制定改善睡眠的策略，作为这一高危人群预防心血管疾病的新疗法。

DESCRIPTION (provided by applicant): With technological advances such as electricity and the internet, humans are increasingly living in a 24-hour society that has led to substantial changes in sleeping patterns including a 2 hour reduction in average sleep duration among US adults over the past 80 years. Preliminary studies suggest that altered sleep including reductions in amount, quality, and regularity are associated with up to a 3-fold increase in the risk of cardiovascular disease (CVD) and CVD risk factors such as obesity, diabetes, and hypertension. Thus, effects on sleep may reflect one of the mechanisms by which a 21st century lifestyle predisposes to heart disease. However, the existing literature that has addressed the role of sleep largely has been limited by the lack of objective measurements of sleep and has not included a representative sample of ethnic minorities, who are at greatest risk for poor sleep. In the proposed ancillary study to the Hispanic Community Health Study (HCHS), a large US community based cohort of four Hispanic-American groups, we aim to fill this gap by collecting objective measurements of sleep patterns in 2000 study participants who are already undergoing rigorous assessment of a broad range of CVD risk factors and outcomes. Capitalizing on the HCHS resource and expanding assessments to include objective sleep pattern measurements, will provide unique and efficient opportunities to: (1) assess the prevalence of altered sleep patterns in Hispanic-Americans and assess variability among ethnic subgroups; (2) define the importance of psychosocial factors such as socioeconomic status, factors in the home and work environment and mood as well as cultural factors specific to Hispanic-Americans such as acculturation, familism, and beliefs about sleep, in predicting abnormal sleep patterns; and (3) assess the association between poor sleep and relevant cardiovascular health outcomes including obesity, hypertension, diabetes, and heart disease in Hispanic-Americans. The proposed new data and analyses will help clarify the role of sleep disorders in the development of CVD while also providing insight into the factors most responsible for poor sleep habits in the largest minority group in the US, thus establishing a framework for the development of strategies to improve sleep as a novel treatment for CVD prevention in this at risk population. PUBLIC HEALTH RELEVANCE: Over the past century, the amount of time that people spend sleeping has steadily dropped and this appears to be particularly true in minority groups. Prior research has suggested poor sleep may be a risk factor for heart disease, obesity, and diabetes. In this study, we propose to perform a comprehensive evaluation of sleep habits in 2,000 Hispanic-Americans in order to understand the factors that influence sleep behaviors as well as to better understand how poor sleep may affect heart disease and related disorders.