Determinants and Cardiovascular Consequences of Disparities in Sleep and Circadian Rhythms between Black and White Adults

黑人和白人成年人睡眠和昼夜节律差异的决定因素和心血管后果

• 批准号: 9976782
• 负责人: Mercedes Renee Carnethon
• 金额: $ 222.59万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9976782
• 关键词: Adult; Affect; Ancillary Study; Behavior; Behavioral; Biological; Biological Factors; Blood Pressure; Businesses; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chicago; Chronic Kidney Failure; Circadian Dysregulation; Circadian Rhythm Disorder; Circadian Rhythms; Clinical; Coronary Artery Risk Development in Young Adults Study; Cross-Sectional Studies; Data; Devices; Diabetes Mellitus; Diagnosis; Environment; Environmental Risk Factor; Goals; Health; Health behavior; Heart failure; Hispanics; Home environment; Household; Hypertension; Intervention; Latino; Light; Measurement; Measures; Mediating; Neighborhoods; Noise; Obesity; Obstructive Sleep Apnea; Outcome; Participant; Patient Self-Report; Pattern; Pollution; Population; Questionnaires; Race; Reporting; Research Design; Research Personnel; Resources; Rest; Risk Factors; Severities; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Source; Standardization; Stroke; Temperature; Testing; Time; Woman; Wrist; actigraphy; aged; black/white disparity; blood pressure regulation; cardiovascular disorder risk; cardiovascular health; circadian; cohort; early onset; experience; follow-up; health equity; human old age (65+); hypertension control; individual variation; middle age; preference; psychological distress; psychological stressor; psychosocial; racial disparity; screening; sex; sleep behavior; sleep quality; social factors; social stressor; socioeconomics

Over one quarter of the adult population experiences sleep and circadian disturbances, characterized by inadequate sleep duration, poor sleep quality, the presence of sleep disorders and non-optimal timing of sleep. Non-white racial groups, Hispanic/Latinos and adults with fewer socioeconomic resources have a higher burden of sleep and circadian disturbances than their counterparts. Limitations of these prior studies include cross-sectional study designs, self-reported sleep, and incomplete assessment of sleep and circadian rhythms. The objective of our study is to identify a set of modifiable factors that explain racial disparities in sleep and circadian disturbances between black and white middle-aged adults. We will additionally test whether these sleep and circadian disparities account for disparities in blood pressure control. Our overall hypothesis is that black participants have a greater burden of adverse health behaviors, adiposity, psychological and social stressors, and environmental insults at the neighborhood and household level that contribute to more sleep and circadian disturbances as compared with whites. To accomplish our goal, we will conduct an ancillary study in 2,500 adults (45% black and 60% women) aged 53-65 years old at the upcoming 35-year follow-up examination of the Coronary Artery Risk Development in Young Adults (CARDIA) study. All participants will undergo wrist actigraphy for 7 days, obstructive sleep apnea severity (OSA) determined using an in-home screening device, and sleep behaviors, diagnoses of sleep disorders and sleep quality via questionnaire. In a subset of 1,000 participants from the Chicago and Birmingham field centers, we will assess the neighborhood and household environment using a combination of secondary sources (e.g., traffic data), questionnaires and recording devices to capture household noise, light and temperature. We will combine these newly collected data with the wealth of information that will be determined in the core CARDIA examination and that has been collected in a standardized manner across 8 prior examinations. The Specific Aims of our study are as follows: 1) Determine the contribution of behavioral, psychosocial, and clinical characteristics over 35 years on racial disparities in sleep and circadian disturbances in middle-age; 2) Identify environmental factors associated with racial disparities in 7-day average and intra-individual variability (day-to-day changes) in sleep duration and quality; and, 3) Quantify the contribution of sleep and circadian disturbances on racial disparities in blood pressure levels in the estimated 60% of participants with hypertension. We will additionally explore whether sex as a biological variable modifies the hypothesized associations across all Aims. Our proposed study is a timely acknowledgement of the significance of sleep to racial disparities in cardiovascular health. We anticipate that our findings will have a sustained impact on a broad set of stakeholders, including clinicians, researchers, policymakers and middle-aged adults who are looking for intervention targets to reduce racial disparities in sleep and circadian rhythms that will promote cardiovascular health equity.

超过四分之一的成年人经历睡眠和昼夜节律紊乱，其特征是 睡眠时间不足、睡眠质量差、存在睡眠障碍和非最佳睡眠时间。 非白人种族群体、西班牙裔/拉丁裔和社会经济资源较少的成年人拥有更高的 睡眠负担和昼夜节律紊乱的程度高于同龄人。这些先前研究的局限性包括 横断面研究设计、自我报告的睡眠以及对睡眠和昼夜节律的不完整评估。 我们研究的目的是确定一组可改变的因素来解释睡眠和睡眠方面的种族差异。 黑人和白人中年人之间的昼夜节律紊乱。我们将另外测试这些是否 睡眠和昼夜节律的差异导致了血压控制的差异。我们的总体假设是 黑人参与者在不良健康行为、肥胖、心理和社会方面承受着更大的负担 邻里和家庭层面的压力源和环境侵害有助于增加睡眠 与白人相比，昼夜节律紊乱。为了实现我们的目标，我们将进行辅助 在即将到来的 35 年随访中，对 2,500 名 53-65 岁成年人（45% 黑人和 60% 女性）进行了研究 年轻人冠状动脉风险发展（CARDIA）研究的检查。所有参与者将 进行 7 天的腕部活动记录仪，使用家用设备确定阻塞性睡眠呼吸暂停严重程度 (OSA) 筛查设备，通过问卷调查睡眠行为、睡眠障碍诊断和睡眠质量。在一个 来自芝加哥和伯明翰现场中心的 1,000 名参与者的子集，我们将评估社区 结合二手来源（例如交通数据）、问卷调查和家庭环境 记录家庭噪音、光线和温度的设备。我们将把这些新收集到的 具有丰富信息的数据将在核心 CARDIA 检查中确定，并且已被 之前的 8 次检查以标准化方式收集。我们研究的具体目标如下： 1) 确定 35 年来行为、心理社会和临床特征对种族的贡献 中年人的睡眠差异和昼夜节律紊乱； 2) 确定与相关的环境因素 睡眠持续时间的 7 天平均值和个体内差异（每日变化）存在种族差异， 质量; 3) 量化睡眠和昼夜节律紊乱对血液种族差异的影响 估计 60% 的参与者患有高血压。我们还将进一步探讨是否 性别作为一个生物变量改变了所有目标的假设关联。我们提出的研究是 及时承认睡眠对心血管健康种族差异的重要性。我们 预计我们的研究结果将对包括临床医生在内的广泛利益相关者产生持续影响， 正在寻找干预目标以减少种族歧视的研究人员、政策制定者和中年人 睡眠和昼夜节律的差异将促进心血管健康公平。