Environmental Determinants of Sleep Disparities and the Consequences for Low Income Children with Asthma

哮喘和睡眠呼吸障碍(SDB)是常见的慢性疾病 对黑人儿童和生活在贫困社区的儿童造成不成比例的影响。居家 环境暴露已被证明会增加哮喘的发病率，而且有很强的 这些会影响睡眠质量的生物学原理，但到目前为止，研究还很有限 室内环境和睡眠。我们的首要目标是定义家居环境 睡眠差异的决定因素及睡眠差异对儿童哮喘的影响 巴尔的摩市以黑人为主的低收入儿童的发病率。《家》 环境是至关重要的，因为孩子们大部分时间都呆在室内，大部分时间都在自己的家里 卧室里有1/3，这是与睡眠最相关的环境。我们建议 全面研究卧室环境，包括空气质量、过敏原、微生物和 哮喘儿童睡眠质量与睡眠质量的关系我们之前的研究表明， 巴尔的摩市的儿童生活在卧室空气污染水平是 世界卫生组织室内空气质量标准和 这种高浓度的老鼠过敏原是巴尔的摩哮喘发病率的驱动因素。 卧室粉尘和鼻腔携带金黄色葡萄球菌很普遍，并正在出现 有证据表明，卧室暴露在这种细菌及其有毒蛋白质产品中 与夜间哮喘有关。有生物学上的证据表明卧室的环境 暴露会增加上呼吸道的炎症和氧化应激反应， 增加SDB的风险和严重性。虽然有新的证据表明环境问题 暴露会影响睡眠，因此有必要对儿童进行客观评估的研究。我们的 研究团队在家庭环境监测和管理方面拥有丰富的经验 同时评估儿童的健康结果。在建议的项目中，我们的目标是 确定a)卧室环境暴露(空气质量、过敏原、 巴尔的摩市卧室哮喘儿童的睡眠质量 环境暴露与上呼吸道炎症/氧化应激3)睡眠质量和 巴尔的摩市哮喘儿童的哮喘发病率。这项全面的研究 市中心非裔美国儿童的卧室环境和睡眠状况有可能 为睡眠质量差的环境驱动因素提供基础证据 设计干预措施以减少睡眠和哮喘的健康差距。

Asthma and sleep disordered breathing (SDB) are common chronic diseases that disproportionately affect Black children and those living in poor neighborhoods. Household environmental exposures have been shown to increase asthma morbidity and there is strong biologic rationale that these will impact sleep quality, but to date, there have been limited studies of the indoor environment and sleep. Our overarching goal is to define home environmental determinants of sleep disparities and the contribution of sleep disparities to childhood asthma morbidity among low-income, predominantly Black children living in Baltimore City. The home environment is critical as children spend the majority of their time indoors, most in their own home and ~1/3 in the bedroom, the environment most relevant for sleep. We propose to comprehensively study the bedroom environment, including air quality, allergens, microbes, and the relationship with sleep quality in children with asthma. Our prior studies have shown that children in Baltimore City live in homes where bedroom levels of air pollution are three times the concentrations recommend by the World Health Organization Indoor Air Quality standards and that mouse allergen, present in high concentrations, is a driver of asthma morbidity in Baltimore. Bedroom dust and nasal carriage of Staphylococcus aureus are prevalent, and emerging evidence suggests bedroom exposure to this bacteria and its toxic protein products are associated with nocturnal asthma. There is biological plausibility that the bedroom environmental exposures increase inflammation and oxidative stress responses in the upper airway that contribute to risk for and severity of SDB. While there is emerging evidence that environmental exposures impact sleep, there is a need for studies with objective assessments in children. Our research team has extensive experience in the conduct of home environmental monitoring and simultaneously assessing health outcomes in children. In the proposed project, we aim to determine the association between a) bedroom environmental exposures (air quality, allergens, microbes) and sleep quality among children with asthma in Baltimore City 2) bedroom environmental exposures and upper airway inflammation/oxidative stress 3) sleep quality and asthma morbidity among children with asthma in Baltimore City. This comprehensive study of bedroom environment and sleep among inner-city African American children has the potential to provide foundational evidence for environmental drivers of poor sleep quality that are needed to design interventions to reduce sleep and asthma health disparities.