Stress, Sleep and Cardiovascular Risk

压力、睡眠和心血管风险

基本信息

批准号：
9897585
负责人：
THOMAS A MELLMAN
金额：
$ 45.61万
依托单位：
HOWARD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9897585
关键词：
Affect African American Arousal Autonomic nervous system Behavior Biological Markers Blood Pressure Cardiovascular Diseases Cardiovascular system Cell Adhesion Molecules Censuses Cognition Cognitive Disease Distress Electrocardiogram Endothelium Environment Equilibrium Evaluation Excretory function Feedback Frequencies Fright Goals Homeostasis Hour Inflammation Inflammatory Interleukin-6 Intervention Measures Minority Modeling Neighborhoods Observational Study Outcome Parasympathetic Nervous System Participant Pathogenesis Patient Self-Report Physiologic pulse Post-Traumatic Stress Disorders Preventive Intervention Questionnaires Recommendation Regression Analysis Risk Risk Factors Role Severities Signal Transduction Sleep Sleep disturbances Stress Sympathetic Nervous System Thinking Time Trauma Work arterial stiffness base blood pressure reduction brief intervention cardiovascular disorder risk cardiovascular health cardiovascular risk factor coping cytokine endothelial dysfunction experience health disparity heart rate variability immune activation improved indexing noradrenergic post-traumatic stress post-traumatic symptoms scale up sleep behavior sleep health sleep onset trauma exposure urinary vigilance

项目摘要

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.

遇到的邻里环境，创伤后压力和睡眠不足是相互关联的所有与影响城市少数群体的健康差异有关的问题。在我们最近的工作中我们发现自我报告和普查衍生的邻里疾病指标之间的显着关系，自我报告，睡眠发作后的习惯唤醒（WASO），夜间血压降低（BP）蘸酱，这是不良心血管结局的良好危险因素，并且代表性过高在非裔美国人中。除了减少BP外，通常还有向副交感神经转变在睡眠和证据期间，自主神经系统（ANS）的优势表明这种转变是对于健康的心血管稳态至关重要。初步发现表明这种转变可以是在压力大的邻里环境中被PTSD和夜间警惕性妥协。拟议研究的目标是进一步建立和扩展一个模型，在其中创伤和威胁性环境引起夜间警惕和与睡眠有关的恐惧，损害健康 SNS的降低和PNS活性在睡眠期间的增加，这反过来刺激了动脉粥样硬化的分泌体液因素，动脉僵硬和心血管疾病风险。我们将研究前袖子的角色使用问卷和实时评估的认知，以及应对睡眠的可修改策略破坏性认知。然后，我们将评估提供个性化反馈和根据有关参与者如何应对潜在睡眠破坏性的研究观察的建议认知和睡眠效率。我们还将确定是否更健康与睡眠相关的行为（但是实现的）将影响睡眠和心血管风险生物标志物期间ANS平衡的变化。因此研究发现将确认并揭示与压力和睡眠有关的心血管发病机理的生物标志物在可诊断疾病之前的破坏，确定预防性干预的目标并提供评估作为研究发现的简短干预措施，可以扩展或构建。