Sleep and Circadian Dysregulation in Pediatric Bipolar Disorder

小儿双相情感障碍的睡眠和昼夜节律失调

• 批准号: 8635600
• 负责人: Anda Gershon
• 金额: $ 18.07万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8635600
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Attention deficit hyperactivity disorder; Bipolar Disorder; Child; Childhood; Circadian Dysregulation; Circadian Rhythms; Clinical; Clinical Research; Control Groups; Coupling; Data; Dependence; Development; Diagnosis; Disease; Early Diagnosis; Environment; Exhibits; Fostering; Functional disorder; Home environment; Incidence; Intervention; Investigation; Knowledge; Laboratories; Life; Link; Literature; Manic; Measures; Mental Depression; Mentored Research Scientist Development Award; Mentorship; Monitor; Mood Disorders; Moods; Nature; Outcome; Parents; Patient Self-Report; Pattern; Phase; Polysomnography; Population; Psychopathology; Publications; Questionnaires; Relative (related person); Reporting; Research; Research Personnel; Research Project Grants; Risk; Role; Sampling; Series; Severities; Sleep; Sleep Architecture; Sleep Disorders; Sleep Fragmentations; Social Interaction; Staging; Stress; Symptoms; Testing; Time; Training; Universities; Youth; actigraphy; base; career; childhood bipolar disorder; density; high risk; improved; non rapid eye movement; novel; novel marker; outcome forecast; prevent; programs; public health relevance; research study; sleep onset; social; training project

Project Summary The purpose of this K01 Mentored Research Scientist Development Award application is to facilitate my training in the field of sleep and pediatric bipolar disorder (PBD) and in so doing, support my short-term objectives to: (1) comprehensively characterize sleep and circadian rhythms in adolescents with bipolar disorder (BD), and (2) investigate the relationship between sleep/circadian dysregulation and mood dysregulation in this population. The proposed training and research project represent the key first step in laying the groundwork for a long-term independent, academic, clinical research career focused on sleep and circadian dysregulation in the onset, development, course, and treatment of pediatric mood disorders. Multiple lines of evidence suggest that sleep/circadian disruptions are core features of adult BD, and that these disruptions may trigger episodes of illness. However, there is virtually no information on the nature and severity of sleep/circadian disruption in PBD, or on the potential contribution of sleep/circadian disruption to mood dysregulation. Given incidence rates of BD peak during adolescence and that BD is associated with particularly devastating outcomes when onset is early in life, adolescence offers a critical window for understanding the development of this disorder. Previous studies assessing sleep and circadian functioning in PBD samples have largely relied on subjective measures. The proposed research study will be the first to use a comprehensive, ecologically sensitive, and objective characterization of sleep/circadian rhythms in adolescents with BD relative to controls. This assessment combines two nights of ambulatory polysomnography (PSG), along with a two- week observation period of continuous actigraphy, and daily monitoring of subjective sleep, social rhythms, and affect. Daily measures of social interaction, stress, and rumination will also be collected. By investigating sleep in bipolar youth, the proposed study aims to address a gap in knowledge on the role of sleep and circadian disruption in the early development and progression of PBD. The hypotheses predict group differences in: (H1a) sleep architecture, specifically sleep efficiency, REM latency, and REM density and duration; (H1b) sleep and wake durations, sleep fragmentation, and daytime activity level; (H1c) overall rates of sleep disorders; (H1d) subjective sleep measures and regularity of social rhythms. The proposed investigation will also examine a potential link between daily sleep and daily affect in order to test for group differences in (H2) the degree of sleep-affect coupling. The proposed integrated program of research, mentorship and didactic training, combined with the outstanding research environment at Stanford University will foster my long-term career objective to be an independent investigator of sleep and circadian mechanisms in pediatric mood disorders. !

项目摘要 这个K 01指导研究科学家发展奖申请的目的是为了方便我 睡眠和儿科双相情感障碍（PBD）领域的培训，并在此过程中支持我的短期 目的：（1）全面描述青少年双相情感障碍患者的睡眠和昼夜节律 （2）研究睡眠/昼夜节律失调与情绪之间的关系 在这个人群中失调。拟议的培训和研究项目是关键的第一步， 为长期的独立，学术，临床研究职业生涯奠定基础，重点是睡眠， 儿童情绪障碍的发病、发展、病程和治疗中的昼夜节律失调。 多条证据表明，睡眠/昼夜节律中断是成人BD的核心特征， 干扰可能引发疾病发作。然而，几乎没有任何资料说明这一事件的性质和严重程度， PBD中睡眠/昼夜节律紊乱的可能性，或睡眠/昼夜节律紊乱对情绪的潜在影响 失调考虑到BD的发病率在青春期达到高峰， 当发病是在生命的早期，毁灭性的结果，青春期提供了一个关键的窗口，了解 这种疾病的发展。先前评估PBD样本中睡眠和昼夜节律功能的研究 很大程度上依赖于主观测量。拟议的研究将是第一个使用全面的， BD相关青少年睡眠/昼夜节律的生态敏感性和客观特征 控制。这项评估结合了两个晚上的动态多导睡眠图（PSG），沿着两个- 连续体动记录仪的一周观察期，以及主观睡眠，社会节律， 和影响。还将收集日常社会交往、压力和反刍的测量结果。通过调查 睡眠在双相青年，拟议的研究旨在解决知识的差距，对睡眠的作用， 在PBD的早期发展和进展中的昼夜节律破坏。假设预测群体 差异：（H1 a）睡眠结构，特别是睡眠效率，REM潜伏期和REM密度， 持续时间;（H1b）睡眠和觉醒持续时间、睡眠片段和日间活动水平;（H1 c）总体比率 睡眠障碍;（H1 d）主观睡眠测量和社会节奏的规律性。拟议 调查还将检查日常睡眠和日常情绪之间潜在联系， （H2）睡眠影响耦合程度的差异。 建议的研究，导师和教学培训的综合方案，结合优秀的 斯坦福大学的研究环境将促进我的长期职业目标，成为一个独立的 儿童情绪障碍睡眠和昼夜节律机制的研究者。 !