Disrupted Sleep in Somali Americans – Implications for Hypertension Risk

睡眠中断是一个主要的公共健康问题，它独立地增加了患心血管疾病的风险 (CVD)。黑人的睡眠缺乏率有所增加，这可能被低估了。重要的是，这些 数据主要涉及西非血统的数据。我们目前对黑人睡眠障碍的了解， 已经受到严格限制的范围，不能轻易地适用于索马里裔美国人。大多数索马里人 移民已经在明尼苏达州定居，这让我们位于明尼苏达州的研究团队处于独特的地位 全面研究睡眠中断作为心血管调节因子的机制和后果 这一人群中的健康差距。我们的初步数据显示，索马里裔美国人很有可能 睡眠中断的风险，这可能会增加他们患高血压和其他心血管疾病的风险。潜在的 社会文化、行为、环境和生物因素可能导致睡眠风险增加 不足之处。因此，我们提出了一种使用社会生态学模型的跨学科方法。 由国家少数民族健康和健康差距研究所(NIMHD)研究提供信息 确定其他健康人群中未诊断的睡眠不足的类型和严重程度的框架 索马里裔美国人，找出导致他们睡眠中断的机制，并研究 睡眠不足导致血压升高。我们的中心假设是索马里裔美国人将 睡眠不足的可能性很高，部分原因是独特的多层次个人，心理社会， 环境和行为因素，产生有害的生物影响。我们提出以下目标： 目标1：确定以前未诊断出的睡眠不足的类型和严重程度 健康的索马里裔美国人。假设1：索马里裔美国人有很高(50%)的可能性 未确诊的睡眠不足(睡眠不足(&lt；6小时)、失眠和阻塞性睡眠呼吸暂停)。 目标2：应用NIMHD研究框架来定义心理社会、行为、环境和 索马里裔美国人睡眠不足的生物学机制。假设2：独一无二 多层次的个人、文化和环境风险和保护因素在 调解索马里裔美国人睡眠中断的可能性增加。 目的3：研究索马里裔美国人睡眠不足与血压升高之间的关系。 假设3：在睡眠中断的受试者中，清醒和/或睡眠期间的血压会增加， 与睡眠不足的类型和严重程度相称，并受性别和年龄等因素的影响。 这项提案的预期结果将是一条包含NIMHD研究的机械途径 确定调节睡眠不足的心理社会、行为、背景和生物因素的框架 以及相关的血压增加，从而导致高血压风险，从而解决了重要的知识 索马里裔美国人在理解与睡眠相关的健康差距及其后果方面存在差距。

Disrupted sleep, a major public health issue, independently increases risk for cardiovascular disease (CVD). Blacks have increased rates of sleep deficiency, which are likely under-reported. Importantly, these data relate primarily to those of West African ancestry. Our current knowledge of sleep disruption in Blacks, already severely limited in scope, cannot be readily applied to Somali Americans. The majority of Somali immigrants have settled in Minnesota, placing our Minnesota-based research team in a unique position to comprehensively study the mechanisms and consequences of disrupted sleep as a mediator of cardiovascular health disparities in this population. Our preliminary data suggest that Somali Americans have a high likelihood of disrupted sleep, which may put them at increased risk for hypertension and other CVD. Underlying sociocultural, behavioral, environmental and biological factors likely contribute to an increased risk for sleep deficiencies. We therefore propose an inter-disciplinary approach using a socioecological model informed by the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to determine the types and severity of undiagnosed sleep deficiencies in otherwise healthy Somali Americans, identify mechanisms contributing to their disrupted sleep, and examine the role of sleep deficiencies in raising blood pressure (BP). Our central hypothesis is that Somali Americans will have a high likelihood of sleep deficiencies attributable in part to unique multilevel individual, psychosocial, contextual and behavioral factors, which exert deleterious biological effects. We propose the following aims: Aim 1: Determine the types and severity of previously undiagnosed sleep deficiencies in otherwise healthy Somali Americans. Hypothesis 1: Somali Americans have a high (>50%) likelihood of previously undiagnosed sleep deficiencies (short sleep (<6 hours), insomnia and obstructive sleep apnea). Aim 2: Apply the NIMHD Research Framework to define psychosocial, behavioral, environmental and biological mechanisms mediating sleep deficiencies in Somali Americans. Hypothesis 2: Unique multilevel individual, cultural and environmental risk and protective factors play a mechanistic role in mediating an increased likelihood of disrupted sleep in Somali Americans. Aim 3: Examine the relationship between sleep deficiencies and increased BP in Somali Americans. Hypothesis 3: BP during wakefulness and/or sleep will be increased in those subjects with disrupted sleep, commensurate with type and severity of sleep deficiency, and moderated by factors such as sex and age. The expected outcome of this proposal will be a mechanistic pathway incorporating the NIMHD Research Framework to identify psychosocial, behavioral, contextual and biological factors mediating sleep deficiencies and related increases in BP, and consequently hypertension risk, thus addressing important knowledge gaps in understanding sleep-related health disparities and their consequences in Somali Americans.