Sleep deficiency and autonomic function in pediatric chronic abdominal pain

项目总结/摘要 儿童慢性腹痛是非常普遍的，并与显着较差的身体和 心理社会功能，以及学校缺勤率增加。此外，这些儿童面临的风险更大， 成年后出现慢性腹痛、重叠疼痛综合征和心理社会功能障碍。 慢性疼痛已经成为一种公共卫生危机，每年的成本超过6000亿美元。目前该 慢性腹痛的潜在机制尚不清楚，限制了 干预措施。现在有令人信服的证据表明，睡眠不足可能是疼痛发展的前兆。 此外，睡眠不足与植物神经功能障碍和情感障碍有关， 报告的慢性腹痛的个人，强调共同的中枢神经生物学过程。 了解睡眠不足作为慢性腹痛的潜在机制的作用将扩大 治疗的途径。这项研究计划的长期目标是开发新的策略， 慢性腹痛的轨迹本申请的目的是阐明纵向 睡眠不足对青少年腹痛病程的影响，并阐明 自主和心理功能在这种关系。K23候选人是助理教授， 华盛顿大学麻醉学和疼痛医学系， 西雅图儿童医院的内科医生和麻醉师。该提案概述了一项综合性很强的研究， 和培训计划的指导，病人为导向的职业发展，由一个跨学科的团队支持， 在青少年发展，心理生理学研究，纵向建模，和 临床研究应用。该奖项将为候选人提供专业指导， 儿童腹痛人群的睡眠和心脏生理学生物标志物的评估，以及专业知识 进行纵向研究。主要目的是比较睡眠不足，疼痛处理， 慢性腹痛青少年与健康青少年的自主神经和心理功能比较 青少年（研究1），并评估这些纵向轨迹和相互关系的青少年 与健康青少年相比，慢性腹痛超过6个月（研究2）。评估将 包括对疼痛、自主神经和心理功能主观评价 睡眠模式的活动记录监测将与心理物理疼痛的实验室评估配对 任务和心率变异性。本研究生成的数据将直接为计划的R 01提案提供信息 制定针对睡眠不足和自主神经功能的定制干预措施，作为可改变的风险因素， 治疗完成拟议的培训将为候选人成功地独立工作做好准备。 儿科慢性腹痛医学的研究生涯。

Project Summary/Abstract Childhood chronic abdominal pain is highly prevalent, and associated with significantly poorer physical and psychosocial functioning, and increased school absenteeism. Moreover, these children are at a greater risk of becoming adults with chronic abdominal pain, overlapping pain syndromes and psychosocial dysfunction. Chronic pain has become a public health crisis, with annual costs exceeding $600 billion. At present, the mechanisms underlying chronic abdominal pain are not well understood, limiting the development of interventions. There is now compelling evidence that sleep deficiency may be a precursor of pain development. Additionally, sleep deficiency is associated autonomic dysfunction and affective disorders that are commonly reported by individuals with chronic abdominal pain, highlighting shared central neurobiological processes. Understanding the role of sleep deficiency as a potential mechanism of chronic abdominal pain will expand avenues for treatment. The long term goal of this research program is to develop novel strategies to interrupt the trajectories of chronic abdominal pain. The objectives of this application are to elucidate the longitudinal impact of sleep deficiency on the course of abdominal pain in adolescents, and to delineate the roles of autonomic and psychological function in this relationship. The K23 candidate is an Assistant Professor in the Department of Anesthesiology and Pain Medicine at the University of Washington, and a pediatric pain physician and anesthesiologist at Seattle Children's Hospital. This proposal outlines a well-integrated research and training plan for mentored, patient oriented career development supported by an interdisciplinary team of mentors with expertise in adolescent development, psychophysiological research, longitudinal modeling, and clinical research applications. This award will provide the candidate with specialized instruction in the evaluation of sleep and cardiophysiological biomarkers in pediatric abdominal pain populations, and expertise in the conduct of longitudinal studies. The central aims are to compare sleep deficiency, pain processing, autonomic and psychological function in adolescents with chronic abdominal pain compared to healthy adolescents (Study 1); and to evaluate these longitudinal trajectories and inter-relationships for adolescents with chronic abdominal pain compared to healthy adolescents over 6 months (Study 2). Assessments will include subjective evaluation of pain, autonomic and psychological function, in addition to home-based actigraphy monitoring of sleep patterns that will be paired with laboratory assessment of psychophysical pain tasks and heart rate variability. Data generated from this research will directly inform a planned R01 proposal to develop tailored interventions targeting sleep deficiency and autonomic function as modifiable risk factors for treatment. Completion of the proposed training will prepare the candidate for a successful independent research career in pediatric chronic abdominal pain medicine.