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Stress, Sleep and Cardiovascular Risk

压力、睡眠和心血管风险

基本信息

批准号：
10421595
负责人：
THOMAS A MELLMAN
金额：
$ 1.94万
依托单位：
HOWARD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10421595
关键词：
Affect African American Arousal Autonomic nervous system Behavior Biological Markers Blood Pressure Cardiovascular Diseases Cardiovascular system Cell Adhesion Molecules Censuses Cognition Cognitive Disease Distress Electrocardiogram Endothelium Environment Equilibrium Evaluation Excretory function Feedback Frequencies Fright Goals Homeostasis Hour Inflammation Inflammatory Interleukin-6 Intervention Measures Modeling Neighborhoods Observational Study Outcome Parasympathetic Nervous System Participant Pathogenesis Patient Self-Report Physiologic pulse Post-Traumatic Stress Disorders Questionnaires Recommendation Regression Analysis Risk Risk Factors Role Severities Signal Transduction Sleep Sleep disturbances Stress Sympathetic Nervous System Thinking Time Trauma Work arterial stiffness base blood pressure reduction brief intervention cardiovascular disorder risk cardiovascular health cardiovascular risk factor coping cytokine endothelial dysfunction experience health disparity heart rate variability immune activation improved indexing noradrenergic post-traumatic stress post-traumatic symptoms preventive intervention scale up sleep behavior sleep health sleep onset trauma exposure urban minority urban setting urinary vigilance

项目摘要

Distressed neighborhood environments, posttraumatic stress, and compromised sleep are inter-related problems that have all been implicated in the health disparities affecting urban minorities. In our recent work we found significant relationships between self-reported and census-derived indices of neighborhood disorder, and self-reported, habitual wake after sleep onset (WASO), with diminished nocturnal blood pressure (BP) dipping, which is a well-established risk factor for adverse cardiovascular outcomes and is over-represented among African Americans. In addition to reduction of BP there is normally a shift toward parasympathetic dominance of the autonomic nervous system (ANS) during sleep and evidence suggests that such shifts are important for healthy cardiovascular homeostasis. Are preliminary findings indicate that this shift can be compromised with PTSD and nocturnal vigilance in stressful neighborhood environments. The goal for the proposed study is to further establish and extend a model where trauma exposure and threatening environments elicit nocturnal vigilance and sleep-related fears that compromise the healthy reduction of SNS and rise in PNS activity during sleep which in turn stimulates secretion of atherogenic humoral factors, arterial stiffening, and cardiovascular disease risk. We will examine the roles of pre-sleep cognition using a questionnaire and real time assessment, and modifiable strategies for coping with sleep disruptive cognitions. We will then evaluate the impact of providing personalized feedback and recommendations based on study observations on how participants cope with potentially sleep disruptive cognitions and sleep efficiency. We will also determine whether healthier sleep-related behaviors (however achieved) will influence changes in ANS balance during sleep and cardiovascular risk biomarkers. Thus study findings will confirm and reveal biomarkers of cardiovascular pathogenesis related to stress and sleep disruption that precede diagnosable illness, identify targets for preventive interventions, and provide evaluation of a brief intervention that can be scaled up or built upon as study findings indicate.

痛苦的邻里环境、创伤后压力和睡眠不足是相互关联的这些问题都与影响城市少数群体的健康差距有关。在我们最近的工作中我们发现自我报告的邻里关系紊乱指数和人口普查得出的邻里关系紊乱指数之间存在显著关系，和自我报告的睡眠发作后习惯性觉醒（WASO），夜间血压（BP）降低浸渍，这是一个公认的心血管不良结局的风险因素，在非裔美国人中。除了血压降低外，正常情况下，睡眠期间自主神经系统（ANS）的主导地位，有证据表明，这种变化是对健康的心血管内稳态很重要。初步研究结果是否表明，这种转变可能是创伤后应激障碍和夜间警觉性在紧张的邻里环境中妥协。这项研究的目的是进一步建立和扩展一个模型，危险的环境会引起夜间警觉和睡眠相关的恐惧，睡眠期间SNS减少和PNS活性升高，这反过来刺激动脉粥样硬化物质的分泌，体液因素、动脉硬化和心血管疾病风险。我们将研究睡眠前的作用使用问卷和真实的时间评估的认知，以及应对睡眠的可修改策略破坏性认知然后，我们将评估提供个性化反馈的影响，基于对参与者如何科普潜在睡眠破坏的研究观察的建议认知和睡眠效率。我们还将确定是否更健康的睡眠相关行为（然而，实现）将影响睡眠期间ANS平衡和心血管风险生物标志物的变化。因此，研究研究结果将证实并揭示与压力和睡眠相关的心血管发病机制的生物标志物在可诊断疾病之前中断，确定预防干预的目标，并提供评估一个简短的干预，可以扩大规模或建立在研究结果表明。