Identifying Novel Behavioral Targets for Improving Sleep: A Self-Regulation Model

 描述(由申请人提供)：拟议的K23职业发展奖将使Carmela Alcantara博士能够建立一个独立的行为医学研究计划，重点研究睡眠不足、心理社会脆弱性和健康。要做到这一点，阿尔坎塔拉博士是一名临床心理学家，在种族/少数民族心理健康和健康差异方面拥有专业知识，他首先需要接受健康心理学、睡眠医学和复杂纵向数据分析方面的培训。她组建了一支杰出的多学科导师团队，提供以下方面的培训：(1)健康心理学；(2)睡眠生理学、流行病学和研究方法；(3)对连续和实时收集的复杂纵向数据进行分析；(4)美国睡眠医学委员会颁发的行为睡眠医学认证，包括睡眠评估、多导睡眠图测试、评分和口译方面的教学和临床培训；以及(5)研究传播和专业发展。职业发展计划包括完成哥伦比亚大学梅尔曼公共卫生学院的公共卫生硕士学位。在这本K23中，阿尔坎塔拉博士将测试她的睡眠和心血管健康长期自我调节模型的第一个假说，该模型提出，睡眠不足和自我调节资源之间存在双向的、受试者内部的关联。在美国，有5000多万成年人患有睡眠不足(睡眠数量或质量不足)，与睡眠障碍无关。睡眠不足与数百万美国人的高经济成本、残疾、发病率和死亡有关。虽然种族/民族和社会经济差异在睡眠不足方面有很好的记录，但很少有研究调查导致睡眠差异的具体可改变因素。我将对80名健康的成年人进行一项观察性研究，收集40名 睡眠天数和自我调节任务的表现，使用不显眼和持续的数据收集方法。我将使用(1)活动记录仪收集睡眠时长和睡眠效率的数据，以及(2)生态瞬时评估来监控自我调节资源。我假设，某一晚的睡眠不足与第二天的自我调节资源减少有关；而当天自我调节不足的情况将与当晚更严重的睡眠不足有关(一个双向或控制论的恶性循环)。我还将探讨社会经济地位是否会改变这些关联。很少有简单的解释性模型，带有可检验的假设，导致有针对性的干预来改善睡眠。我提出了一个简单、直观的模型，如果得到支持，将导致简单、可扩展的干预措施，专注于自我调节，从而改善睡眠，进而可能提供实质性的公共健康好处。

 DESCRIPTION (provided by applicant): The proposed K23 career development award will enable Dr. Carmela Alcantara to establish an independent program of research in behavioral medicine that emphasizes the study of sleep deficiency, psychosocial vulnerability, and health. To do so, Dr. Alcantara, a clinical psychologist with expertise in racial/ethnic minority mental health and health disparities, will first require training in health psychology, sleep medicine, an analysis of complex longitudinal data. She has assembled an outstanding multidisciplinary team of mentors to provide training in: (1) health psychology; (2) sleep physiology, epidemiology, and research methods; (3) analysis of complex longitudinal data collected continuously and in real-time; (4) certification in behavioral sleep medicine from the American Board of Sleep Medicine to include didactic and clinical training in sleep assessment, polysomnography testing, scoring, and interpretation; and (5) research dissemination and professional development. The career development plan includes completion of an MPH degree from the Mailman School of Public Health at Columbia University. In this K23, Dr. Alcantara will test the first hypothesis of her lon-term Self-Regulation Model of Sleep and Cardiovascular Health, which proposes that there are bidirectional, within-subject associations between sleep deficiency and self-regulation resources. Over 50 million adults in the United States suffer from sleep deficiency (deficits in th quantity or quality of sleep obtained), independent of sleep disorders. Sleep deficiency is associated with high economic costs, disability, morbidity, and death for millions of Americans. While racial/ethnic and socioeconomic disparities in sleep deficiency are well documented, little research has examined the specific modifiable factors driving sleep disparities. I will conduct an observational study with a single cohort of 80 healthy adults, collecting observational data for 40 days on sleep and performance on self- regulation tasks using unobtrusive and continuous data collection methods. I will use (1) actigraphy to collect data on sleep duration and sleep efficiency, and (2) ecological momentary assessment to monitor self- regulation resources. I hypothesize that sleep deficiency on one night will be associated with less self- regulation resources during the next day; and that less self-regulation during that day will be associated with worse sleep deficiency for that night (a bidirectional or cybernetic, vicious cycle). I will aso explore whether socioeconomic status modifies these associations. Few simple explanatory models with testable hypotheses that lead to targeted interventions to improve sleep have been tested. I propose a simple, intuitive model that, if supported, will lead to simple, scalable interventions focused on self-regulation that could improve sleep, and in turn could provide substantial public health benefit.