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的影响不成比例。家庭 环境暴露已被证明会增加哮喘发病率， 生物学原理，这些将影响睡眠质量，但迄今为止，已经有有限的研究 室内环境和睡眠。我们的首要目标是定义家庭环境 睡眠差异的决定因素及睡眠差异对儿童哮喘的影响 发病率低收入，主要是黑人儿童生活在巴尔的摩市。家庭 环境是至关重要的，因为孩子们大部分时间都在室内，大多数是在自己家里 约1/3在卧室，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， 哮喘儿童睡眠质量的关系。我们之前的研究表明， 巴尔的摩市的儿童居住在卧室空气污染水平是 世界卫生组织室内空气质量标准推荐的浓度， 在巴尔的摩，高浓度的老鼠过敏原是哮喘发病率的驱动因素。 居室灰尘和鼻腔携带的金黄色葡萄球菌普遍存在，并不断出现 有证据表明，卧室暴露于这种细菌及其有毒蛋白质产物， 与夜间哮喘有关。卧室环境有生物相容性 暴露会增加上呼吸道的炎症和氧化应激反应， 有助于SDB的风险和严重程度。虽然有新的证据表明，环境 暴露影响睡眠，需要对儿童进行客观评估的研究。我们 研究团队在家庭环境监测方面拥有丰富的经验， 同时评估儿童的健康状况。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， 在巴尔的摩市的卧室里，哮喘儿童的睡眠质量和呼吸道细菌的数量 环境暴露和上呼吸道炎症/氧化应激3）睡眠质量和 巴尔的摩市儿童哮喘发病率这项全面的研究， 卧室环境和睡眠在市中心的非洲裔美国儿童有潜力， 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，以减少睡眠和哮喘健康差异。

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.