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口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，存在睡眠障碍和睡眠时间不佳。 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 睡眠负担和昼夜节律紊乱比他们的同龄人。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。 我们研究的目的是找出一组可改变的因素来解释睡眠和睡眠中的种族差异 黑人和白人中年人之间的昼夜节律紊乱。我们还将测试这些 睡眠和昼夜节律的差异是血压控制差异的原因。我们的总体假设是 黑人参与者在不良健康行为、肥胖、心理和社会方面的负担更大 邻居和家庭层面的压力源和环境侮辱会导致更多的睡眠 与白人相比，昼夜节律紊乱。为了实现我们的目标，我们将进行一项辅助 在即将到来的35年随访中，对2500名年龄在53-65岁的成年人(45%是黑人，60%是女性)进行研究 青年冠状动脉危险发展检查(CARDIA)研究。所有参与者将 进行为期7天的腕部活动描记，使用家庭护理确定阻塞性睡眠呼吸暂停严重程度(OSA) 筛查设备，睡眠行为，睡眠障碍的诊断和通过问卷调查的睡眠质量。在一个 来自芝加哥和伯明翰赛场中心的1000名参与者组成的子集，我们将评估社区 和家庭环境使用二次来源(例如，交通数据)、问卷和 记录设备，以捕捉家庭噪音、光线和温度。我们将把这些新收集的资料结合起来 具有丰富信息的数据，这些信息将在CARDIA核心检查中确定，并已 在之前的8次检查中以标准化的方式收集。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 中年睡眠和昼夜节律紊乱的差异；2)确定与以下因素相关的环境因素 睡眠时间和睡眠时间的7天平均值和个体内变异性(逐日变化)的种族差异 质量；以及，3)量化睡眠和昼夜节律紊乱对血液中种族差异的影响 估计有60%的高血压参与者的压力水平。我们还将探讨是否 性别作为一个生物变量，改变了所有目标之间的假设联系。我们建议的研究是一项 及时认识到睡眠对心血管健康种族差异的重要性。我们 预计我们的发现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。