Longitudinal measurement of the changing sleep need in adolescence

描述（由申请人提供）：儿童和青少年睡眠不足的负面影响是有据可查的。睡眠不足和白天嗜睡会影响学习成绩、健康和行为。尽管对公共卫生影响的认识日益提高，但我们对青少年睡眠和白天嗜睡的理解仍然存在重大差距。目前，疾病控制中心和国家睡眠基金会建议10-17岁的孩子每天睡8.5-9.5小时。这些指导方针是基于数据显示睡眠倾向是稳定的，甚至在青春期增加。然而，睡眠倾向研究并没有解决睡眠限制对白天功能的影响。大多数试图确定睡眠时间对青少年白天表现的影响的研究都将糟糕的表现与不良的睡眠习惯联系起来，而不是通过实验操纵先前的睡眠时间。此外，没有研究评估睡眠限制的影响是如何随着青春期年龄的变化而变化的。本文提出的纵向研究将使用受试者内剂量反应设计来检验睡眠需求的成熟轨迹，这是由实验中不同的睡眠持续时间与白天功能和嗜睡的关系决定的。80名年龄在10到14岁之间的参与者将进入这项研究，并进行为期4年的研究。因此，纵向研究将涵盖10至18岁的年龄。白天的表现和白天的困倦将在四个晚上的不同场合进行测量，这些晚上的睡眠时间被限制在7小时、8.5小时或10小时。每年，所有参与者将在3个月内完成3种不同的睡眠持续条件。白天的表现以及白天的困倦将在实验室测试中进行测量。在一个简单的警觉性任务和一个更复杂的认知任务上的表现将被评估。白天嗜睡将被客观地测量，使用构成疾病控制中心青少年睡眠指南基础的多重睡眠潜伏期测试。白天的困倦程度也将通过脑电图活动客观地测量，受试者将主观地评价自己的困倦程度和情绪。我们之前的纵向研究表明，在12岁到16岁之间，非快速眼动睡眠期间的慢波脑电图活动急剧下降。该研究将确定睡眠时间与表现或困倦之间关系的年龄轨迹是否与反映在慢波脑电图下降中的青少年脑成熟有关。年龄相关的昼夜节律变化，在受试者保持习惯性睡眠计划的一周内通过活动记录仪确定，将在评估表现与睡眠持续时间的剂量反应曲线的成熟变化时进行统计控制。这项计划的结果将提供第一个纵向剂量反应数据，测量青少年睡眠需求的变化，从而为青少年睡眠卫生提供更明智的建议。

DESCRIPTION (provided by applicant): The negative effects of insufficient sleep in children and adolescents are well documented. Sleep loss and daytime sleepiness impact school performance, health, and behavior. Despite the increasing awareness of the public health impact, major gaps remain in our understanding of adolescent sleep and daytime sleepiness. Currently the Centers for Disease Control and National Sleep Foundation recommend 8.5-9.5 hours of sleep for 10-17 year olds. These guidelines are based on data showing that sleep propensity is stable or even increases across adolescence. However, sleep propensity studies do not address the effects of sleep restriction on daytime functioning. Most studies that have attempted to establish the effects of sleep duration on daytime performance in adolescents have correlated poor performance to poor sleep habits rather than experimentally manipulating prior sleep duration. Moreover, no study has evaluated how the effects of sleep restriction change with age across adolescence. The longitudinal study proposed here will use a within-subject dose-response design to examine the maturational trajectory of sleep need as determined by the relation of experimentally varied sleep duration to daytime functioning and sleepiness. Eighty participants will enter the study between 10 and 14 years of age and be studied for 4 years. Thus, the longitudinal study will cover ages 10 to 18 years. Daytime performance and daytime sleepiness will be measured on separate occasions following four nights with time in bed restricted to 7, 8.5, or 10 hours. Annually all participants will complete the 3 different slee duration conditions within a 3 month period. Daytime performance as well as daytime sleepiness will be measured in laboratory testing sessions. Performance on a simple vigilance task and a more complex cognitive task will be evaluated. Daytime sleepiness will be measured objectively using the same multiple sleep latency test that forms the basis of the Centers for Disease Control adolescent sleep guidelines. Daytime sleepiness will also be measured objectively with theta and alpha electroencephalogram activity, and subjects will subjectively rate their sleepiness and mood. Our previous longitudinal study established that slow wave EEG activity during non-rapid eye movement sleep declines steeply between ages 12 and 16 years of age. The proposed study will determine if the age trajectories of the relations between sleep duration and performance or sleepiness are associated with the adolescent brain maturation reflected in the slow wave EEG decline. Age related circadian changes, determined by actigraphy during a week when subjects keep their habitual sleep scheduled, will be controlled for statistically in the evaluation of maturational changes in the performance vs. sleep duration dose-response curve. The results of this proposed project will provide the first longitudinal dose-response data measuring changes in sleep need across adolescence allowing more informed recommendations for adolescent sleep hygiene.