Stress, Sleep and Cardiovascular Risk

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Distressed neighborhood environments, posttraumatic stress, and compromised sleep are inter-related problems that have all been implicated in the health disparities affecting urban minorities. In our recent work we found significant relationships between self-reported and census-derived indices of neighborhood disorder, and self-reported, habitual wake after sleep onset (WASO), with diminished nocturnal blood pressure (BP) dipping, which is a well-established risk factor for adverse cardiovascular outcomes and is over-represented among African Americans. In addition to reduction of BP there is normally a shift toward parasympathetic dominance of the autonomic nervous system (ANS) during sleep and evidence suggests that such shifts are important for healthy cardiovascular homeostasis. Are preliminary findings indicate that this shift can be compromised with PTSD and nocturnal vigilance in stressful neighborhood environments. The goal for the proposed study is to further establish and extend a model where trauma exposure and threatening environments elicit nocturnal vigilance and sleep-related fears that compromise the healthy reduction of SNS and rise in PNS activity during sleep which in turn stimulates secretion of atherogenic humoral factors, arterial stiffening, and cardiovascular disease risk. We will examine the roles of pre-sleep cognition using a questionnaire and real time assessment, and modifiable strategies for coping with sleep disruptive cognitions. We will then evaluate the impact of providing personalized feedback and recommendations based on study observations on how participants cope with potentially sleep disruptive cognitions and sleep efficiency. We will also determine whether healthier sleep-related behaviors (however achieved) will influence changes in ANS balance during sleep and cardiovascular risk biomarkers. Thus study findings will confirm and reveal biomarkers of cardiovascular pathogenesis related to stress and sleep disruption that precede diagnosable illness, identify targets for preventive interventions, and provide evaluation of a brief intervention that can be scaled up or built upon as study findings indicate.