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: 8816135
• 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/8816135
• 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; Health; 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; research study; sleep onset; social; training project

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：申请 K01 指导研究科学家发展奖的目的是促进我在睡眠和儿科双相情感障碍 (PBD) 领域的培训，并支持我的短期目标：(1) 全面描述双相情感障碍 (BD) 青少年的睡眠和昼夜节律特征，以及 (2) 研究睡眠/昼夜节律失调与情绪失调之间的关系 在这个人群中。拟议的培训和研究项目代表了为长期独立、学术、临床研究生涯奠定基础的关键第一步，重点关注儿科情绪障碍的发病、发展、病程和治疗中的睡眠和昼夜节律失调。多种证据表明，睡眠/昼夜节律紊乱是成人双相情感障碍的核心特征，并且这些紊乱可能引发疾病发作。然而，实际上没有关于 PBD 中睡眠/昼夜节律紊乱的性质和严重程度的信息，也没有关于睡眠/昼夜节律紊乱对情绪失调的潜在影响的信息。鉴于 BD 的发病率在青春期达到峰值，并且在生命早期发病时 BD 与特别具有破坏性的后果相关，青春期为了解这种疾病的发展提供了一个关键的窗口。之前评估 PBD 样本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对双相障碍青少年相对于对照组的睡眠/昼夜节律进行全面、生态敏感和客观表征的研究。该评估结合了两晚的动态多导睡眠图 (PSG)、为期两周的连续体动记录仪观察期以及每日主观睡眠、社交节律和情感监测。还将收集日常社交互动、压力和沉思的测量结果。通过调查躁郁症青少年的睡眠情况，拟议的研究旨在弥补睡眠和昼夜节律紊乱在 PBD 早期发展和进展中的作用的知识空白。这些假设预测了以下方面的群体差异：（H1a）睡眠结构，特别是睡眠效率、快速眼动睡眠潜伏期以及快速眼动睡眠密度和持续时间； (H1b) 睡眠和觉醒持续时间、睡眠碎片和白天活动水平； (H1c) 睡眠障碍的总体发生率； (H1d) 主观睡眠测量和社会节奏的规律性。拟议的调查还将检查日常睡眠和日常情绪之间的潜在联系，以测试 (H2) 睡眠-情绪耦合程度的群体差异。拟议的研究、指导和教学培训综合计划，加上斯坦福大学出色的研究环境，将促进我的长期职业目标，成为小儿情绪障碍睡眠和昼夜节律机制的独立研究者。