Sleep, Biological Stress, and Health among Toddlers Living in Socioeconomically Disadvantaged Homes

项目摘要 健康的睡眠对行为、神经生物学和生理健康都很重要。新兴文献表明 压力生物标志物，如皮质醇，C反应蛋白（CRP）和体重指数（BMI）增加， 年龄较大的儿童和成人没有经常养成健康的睡眠习惯。这些生物标志物 与压力和未来疾病风险增加有关。研究人员认为，来自 种族/少数民族群体和/或生活在社会经济逆境中的人特别容易受到睡眠不佳的影响 从生命的第一年开始。然而，人们对睡眠与睡眠之间的关系知之甚少。 生活在逆境中的幼儿的特征、压力和健康。拟定的研究将 填补这一重大科学空白。这项研究将提高我们对这些关系的理解， 儿童生命中的关键发展期--幼儿期。采用纵向设计， 前瞻性地研究睡眠特征、压力和幼儿健康之间的关系 从12个月到24个月，我们将致力于以下目标：1。检查主观和 12 - 24月龄的客观睡眠特征; 2.检查压力生物标志物的变化， 24个月; 3。研究睡眠与睡眠质量之间的横向和纵向关系， 特征和应激反应; 4.检查横截面和纵向之间的关系 睡眠特征和幼儿行为健康。样本将包括113名生活在 社会经济弱势家庭。将在两个时间点（年龄12个月和 24个月）。关于睡眠特征的数据将包括睡眠持续时间的主观和客观测量， 效率，通过问卷调查、日记和9天/夜的睡眠活动记录仪获得。多系统 压力的生物标志物，包括皮质醇、C反应蛋白、S-IgA和BMI，将被单独测量， 然后将其作为压力的潜在变量进行研究。将测量护理人员报告的行为健康问题 因为它与儿童现在和未来的健康密切相关。经济、环境和 将获得心理逆境，并探讨其与主要变量的关系。 数据分析中将使用广义线性模型。本研究的数据将用于支持未来的 R系列拨款申请旨在进一步了解睡眠，压力和健康之间的关系， 随着时间的推移，对这些儿童进行额外的压力和健康测量，以确定因果关系 并最终测试干预措施的效果，例如那些可能改善睡眠的措施， 有毒压力的风险。虽然我过去的临床和研究经验集中在干预，以支持父母- 孩子与家庭之间的关系生活在逆境中，我职业发展的下一步是获得 培训，以了解睡眠和压力的行为和生物方面，并探讨在何种程度上， 健康的睡眠可以缓冲幼儿在生命早期对慢性压力的压力反应。

PROJECT SUMMARY Healthy sleep is important to behavioral, neurobiological, and physiologic health. Emerging literature suggests that stress biomarkers, such as cortisol, C-reactive protein (CRP), and body mass index (BMI) increase when healthy sleep habits are not regularly practiced among older children and adults. These biomarkers are associated with stress and increased risk for future disease. Researchers suggest that young children from racial/ethnic minority groups and/or living with socioeconomic adversity are especially vulnerable to poor sleep beginning within the first year of life. However, little is known about the relationships among sleep characteristics, stress, and health among very young children living with adversity. The proposed study will address this important scientific gap. This study will improve our understanding of these relationships during a critical developmental period in children's lives – toddlerhood. Using a longitudinal design with repeated measures to prospectively examine the relationships among sleep characteristics, stress, and toddler's health from age 12 months to 24 months, we will address the following aims: 1. Examine changes in subjective and objective sleep characteristics from 12 to 24 months of age; 2. Examine changes in stress biomarkers from 12 to 24 months of age; 3. Examine the cross sectional and longitudinal relationships between sleep characteristics and stress response; 4. Examine the cross sectional and longitudinal relationships between sleep characteristics and toddlers' behavioral health. The sample will include 113 toddlers who live in socioeconomically disadvantaged homes. Data will be collected during at two time points (age 12 months and 24 months). Data on sleep characteristics will include subjective and objective measures of sleep duration and efficiency, obtained with questionnaires, diaries, and 9 days/nights of sleep actigraphy. Multi-systemic biomarkers of stress including cortisol, C-reactive protein, S-IgA, and BMI, will be measured individually and then explored as a latent variable of stress. Caregiver-reported behavioral health problems will be measured as it is closely associated with children's present and future health. Indicators of economic, environmental, and psychological adversity will be obtained and their relationships with primary variables will be explored. Generalized linear models will be used in the data analysis. Data from this study will be used to support future R-series grant applications designed to further understand the relationships among sleep, stress, and health by following these children over time with additional measures of stress and health to identify causal pathways and ultimately test the effects of interventions, such as those that may improve sleep, among young children at risk for toxic stress. While my past clinical and research experience focused on interventions to support parent- child relationships among families living with adversity, the next step in my career development is to acquire training to understand behavioral and biological aspects of sleep and stress and to explore the extent to which healthy sleep buffers toddlers' stress response to chronic stress early in life.