Determinants of insufficient sleep among blacks and effects on disparities in health outcomes

黑人睡眠不足的决定因素及其对健康结果差异的影响

• 批准号: 10205152
• 负责人: Girardin Jean-Louis
• 金额: $ 12.06万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10205152
• 关键词: Address; Adverse effects; Amyloid beta-Protein; Area; Attitude; Bayesian learning; Behavior Therapy; Behavioral Medicine; Behavioral Sciences; Belief; Blood Pressure; Brain Injuries; C-reactive protein; Cardiovascular Diseases; Circadian Rhythms; Circadian desynchrony; Communities; Data; Devices; Discrimination; Disease Marker; Dyslipidemias; Emotional; Environment; Environmental Risk Factor; Exhibits; Exposure to; Foundations; Genetic; Glial Fibrillary Acidic Protein; Glucose; Glycosylated hemoglobin A; Goals; Health; Healthy People 2020; Home; Homocysteine; Hour; Household; Individual; Inflammation; Inflammatory; Insulin Resistance; Interleukin-10; Interleukin-6; Intervention; Laboratories; Level of Evidence; Light; Lipids; Longitudinal Studies; Low income; Metabolic syndrome; Modeling; Modification; Monitor; Morbidity - disease rate; Neighborhoods; Noise; Obesity; Outcome; Physiological; Psychosocial Factor; Public Health; Reporting; Research; Research Personnel; Risk; Role; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Sleeplessness; Social support; Socioeconomic Status; TNF gene; Temperature; Time; Translational Research; Underserved Population; United States National Institutes of Health; Volition; Vulnerable Populations; arterial stiffness; base; brain health; built environment; cardiovascular disorder risk; density; disparity reduction; environmental stressor; ethnic minority population; experience; health disparity; high risk; inflammatory marker; innovation; multidisciplinary; neurofilament; novel; novel marker; psychosocial; psychosocial stressors; racial and ethnic; racial and ethnic disparities; recruit; shift work; simulation; social; social capital; stem; success; tau Proteins; tool

Project Summary Insufficient sleep (IS), stemming from sleep apnea, shift work, insomnia, working over 40 hr./week, unfavorable sleep environments and/or volitional reduction of bedtime, is associated with increased risk of cardiovascular disease (CVD) markers (elevated blood pressure, insulin resistance, dyslipidemia and arterial stiffness), inflammatory markers (interleukin-6, tumor necrosis factor-α, and C-reactive protein) as well as with brain injury. Compelling evidence shows racial/ethnic disparities in insufficient sleep (IS), with blacks exhibiting a three-fold greater risk of IS relative to whites. Disparities might arise from physiologic and genetic factors, but recent evidence suggests environmental and psychosocial factors are also critical determinants. This study will utilize innovative dynamic modeling in a multi-level framework to delineate the psychosocial and environmental determinants (associative factors) of actigraphic IS and its putative associations with adverse health outcomes among blacks. Individual- and contextual-level data will be captured using novel home-based recordings and GIS data to model the environmental context where sleep occurs. The proposed study will leverage success of the NYU Sleep Disparity Workgroup led by Dr. Jean- Louis (PI), who has been conducting community-engaged sleep research for over 10 years. The workgroup comprises outstanding investigators with expertise in sleep and circadian rhythm, CVD, brain health, health disparities, translational behavioral medicine, and multi-level dynamic modeling. The study will benefit from experience of our standing Community Steering Committee, enabling recruitment of 560 blacks in various venues to participate in weeklong home studies to achieve proposed study aims. The multidisciplinary team will: 1) identify psychosocial (social support, discrimination, and attitudes/beliefs) and environmental (household [density, noise, light, and temperature], socioeconomic position, social capital, and neighborhood [built environment]) factors that are associated with IS; ascertain effects of IS on (a) markers of CVD (obesity, BP, lipid profile, and glucose/ HbA1C) and inflammation (IL-6, IL-10, and TNF-α) and on (b) markers of brain injury (tau, amyloid-β, neurofilament light, homocysteine, and glial fibrillary acidic protein; and develop profiles of blacks with IS-related adverse health outcomes using individual- and environmental-level data applying innovative multi-level dynamic modeling tools (Bayesia Belief Network and Agent-Based Simulation). This study will provide evidence to delineate factors underlying greater rates of IS among blacks and explain putative associations with markers of CVD, inflammation, and brain injury. These data will provide the foundation for longitudinal studies assessing causal effects of IS on these novel markers and interventions to mitigate adverse effects of IS on health outcomes.

项目概要 睡眠不足 (IS)，源于睡眠呼吸暂停、轮班工作、失眠、每周工作超过 40 小时， 不利的睡眠环境和/或自愿减少就寝时间，与增加的风险相关 心血管疾病 (CVD) 标志物（血压升高、胰岛素抵抗、血脂异常和 动脉僵硬度）、炎症标志物（白细胞介素 6、肿瘤坏死因子 α 和 C 反应蛋白） 以及脑损伤。令人信服的证据表明，睡眠不足 (IS) 方面存在种族/民族差异，其中 黑人患 IS 的风险是白人的三倍。差异可能源于生理 和遗传因素，但最近的证据表明环境和社会心理因素也很重要 决定因素。本研究将利用多层次框架中的创新动态建模来描述 活动记录 IS 及其假定的心理社会和环境决定因素（关联因素） 与黑人不良健康结果的关联。个人和背景级别的数据将 使用新颖的家庭记录和 GIS 数据捕获来模拟睡眠的环境背景 发生。拟议的研究将利用由让博士领导的纽约大学睡眠差异工作组的成功 Louis (PI)，十多年来一直致力于社区参与的睡眠研究。工作组 由在睡眠和昼夜节律、心血管疾病、大脑健康、健康等方面具有专业知识的杰出研究人员组成 差异、转化行为医学和多层次动态建模。该研究将受益于 我们常设社区指导委员会的经验，使 560 名黑人能够在各个领域招募 参加为期一周的家庭学习以实现拟议的学习目标。多学科团队 将：1）确定社会心理（社会支持、歧视和态度/信仰）和环境 （家庭[密度、噪音、光线和温度]、社会经济地位、社会资本和 与信息系统相关的邻里[建筑环境]）因素；确定 IS 对 (a) 标记物的影响 CVD（肥胖、血压、血脂和葡萄糖/HbA1C）和炎症（IL-6、IL-10 和 TNF-α）等 (b) 脑损伤标记物（tau、淀粉样蛋白-β、神经丝光、同型半胱氨酸和胶质纤维酸性 蛋白质;并利用个人和 应用创新的多级动态建模工具（贝叶斯信念网络 和基于代理的模拟）。这项研究将为描述更高比率背后的因素提供证据 黑人中 IS 的影响，并解释了与 CVD、炎症和脑损伤标志物的假定关联。 这些数据将为评估 IS 对这些小说的因果影响的纵向研究提供基础。 减轻信息系统对健康结果不利影响的标记和干预措施。