Stress, Sleep and Cardiovascular Risk

痛苦的邻里环境、创伤后应激障碍和睡眠受损是相互关联的。 这些问题都与影响城市少数群体的健康差距有关。在我们最近的工作中 我们发现，自我报告的邻里混乱指数和人口普查得出的邻里混乱指数之间存在显著的关系， 自我报告，睡眠开始后习惯性醒来(WASO)，夜间血压(BP)降低 浸泡，这是一个公认的心血管不良结局的危险因素，并被过度代表 在非裔美国人中。除了血压降低外，通常还会转向副交感神经。 睡眠期间自主神经系统(ANS)的优势，有证据表明这种变化是 对健康的心血管动态平衡很重要。初步研究结果是否表明，这种转变可能 在压力较大的社区环境中，患有创伤后应激障碍和夜间警觉。 这项拟议研究的目标是进一步建立和扩展创伤暴露和 危险的环境会引起夜间的警觉和与睡眠相关的恐惧，从而危及健康 睡眠中SNS减少和PNS活性升高，进而刺激动脉粥样硬化的分泌 体液因素、动脉硬化和心血管疾病风险。我们将研究睡前的作用 使用问卷和实时评估的认知，以及应对睡眠的可修改策略 颠覆性认知。然后，我们将评估提供个性化反馈和 基于对参与者如何应对潜在睡眠干扰的研究观察提出的建议 认知能力和睡眠效率。我们还将确定更健康的睡眠相关行为(然而 )将影响睡眠期间ANS平衡的变化和心血管风险生物标志物。因此，研究 研究结果将证实并揭示与压力和睡眠有关的心血管发病的生物标记物 在可诊断疾病之前的干扰，确定预防性干预的目标，并提供评估 如研究结果所示，可以扩大或建立短暂的干预。

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.