Socio-ecological factors linked to co-occurring early childhood sleep health disparities and developmental outcomes

项目摘要/摘要 迫切需要解决儿童早期睡眠健康差距，如睡眠不足 对少数族裔儿童造成不成比例的影响，并对关键的神经行为产生负面影响 以及社交-情绪发展。两种常见的儿童早期睡眠不足与不良 结果是(1)睡眠呼吸障碍(SDB)，范围从打鼾症到严重的阻塞性睡眠 睡眠呼吸暂停(OSA)，以及(2)睡眠不足，或睡眠少于基于年龄的24小时睡眠指南。相比较 对于非拉丁裔白人(以下简称白人)青年，非拉丁裔黑人/非裔美国人(以下简称黑人)青年的比例为4-6倍 更有可能经历SDB，也更有可能经历短暂的睡眠持续时间。康体发展局及 睡眠不足也经常出现在幼儿身上。种族差异共生的机制 SDB和睡眠不足及其对发育的影响知之甚少，这阻碍了有效的 干预。这项研究的长期目标是开发利用可修改的多层次干预 减少常见、共生的社会生态因素的发病率和发展后果 学龄前儿童的种族睡眠健康差异。为了实现这一目标，迫切需要确定 造成或缓冲这些差距及其发展影响的因素。虽然 SDB的社会经济差异和睡眠不足是有充分记录的，家庭因素包括照顾者 压力、健康素养和工作时间很少被考虑。很少有研究检查其他可修改的 家庭因素，如就寝时间、就寝电子设备和育儿方法，这可能有助于 或缓冲这些睡眠不足和相关结果的差异。此外，正在进行的个人 黑人家庭面临的居间和结构性种族主义、教师的种族偏见、儿童保育质量以及 社区特征可能是造成这些差异的原因，但对此研究不足。要解决这些问题 这项工作的目的是：(1)研究不同种族之间的差异，并为有效的干预措施提供信息 儿童早期SDB和/或睡眠不足的神经行为和社会情绪影响和(2)确定 近端和远端的社会生态因素与睡眠相关结果中的这些种族差异有关。黑色 白人3-5岁儿童将被招募为(A)SDB，(B)睡眠不足，(C)SDB和不足 睡眠，以及(D)匹配健康对照组，使用多方法、多信息者来检查以下目标 采用护理人员和教师记者的方法、观察任务和定性方法。目标1将 比较神经行为功能(执行功能、注意力、警觉性)和社会-情绪功能(社会功能 技能、情绪调节)在A、B、C和D组中。目标2将确定可改变的家庭因素 与睡眠相关的种族差异在A、B、C、C组黑人和白人儿童的发展结果中 和D.Aim 3将确定近端和远端的儿童保育以及有助于睡眠的社区因素- A组、B组、C组和D组黑人和白人儿童发展结果的相关种族差异。

PROJECT SUMMARY/ABSTRACT There is an urgent need to address pediatric sleep health disparities in early childhood, as sleep deficiencies disproportionately affect racially/ethnically minoritized children and negatively impact crucial neurobehavioral and social-emotional development. Two common early childhood sleep deficiencies linked to adverse outcomes are (1) sleep disordered breathing (SDB), which ranges from snoring to severe obstructive sleep apnea (OSA), and (2) insufficient sleep, or sleeping less than age-based 24-hour sleep guidelines. Compared to non-Latinx White (hereafter ‘White’) youth, non-Latinx Black/African American (‘Black’) youth are 4-6 times more likely to experience SDB and are also more likely to experience short sleep duration. SDB and insufficient sleep also often co-occur in young children. The mechanisms of racial disparities in co-occurring SDB and insufficient sleep and their developmental impacts are poorly understood, which impedes effective intervention. The long-term goal of this research is to develop multi-level interventions that leverage modifiable socio-ecological factors to reduce the incidence and developmental consequences of common, co-occurring racial sleep health disparities in preschoolers. To achieve this goal, there is a critical need to identify the factors that contribute to or buffer against these disparities and their developmental impacts. Although socioeconomic disparities in SDB and insufficient sleep are well documented, family factors including caregiver stress, health literacy, and work schedules are rarely considered. Few studies have examined other modifiable family factors, such as bedtime routines, bedtime electronics, and parenting practices, which may contribute to or buffer against disparities in these sleep deficiencies and related outcomes. Furthermore, ongoing personally mediated and structural racism faced by Black families, teachers’ racial bias, childcare quality, and neighborhood characteristics are likely, but understudied, contributors to these disparities. To address these gaps and inform effective interventions, the objectives of this work are to (1) examine racial disparities in the neurobehavioral and social-emotional impacts of early childhood SDB and/or insufficient sleep and (2) identify proximal and distal socio-ecological factors linked to these racial disparities in sleep-related outcomes. Black and White 3-5-year-olds will be recruited with (A) SDB only, (B) insufficient sleep only, (C) SDB and insufficient sleep, and (D) matched healthy controls to examine the following aims, using a multi-method, multi-informant approach with caregiver and teacher reporters, observational tasks, and qualitative methods. Aim 1 will compare neurobehavioral (executive functioning, attention, vigilance) and social-emotional functioning (social skills, emotion regulation) in groups A, B, C, and D. Aim 2 will identify modifiable family factors that contribute to sleep-related racial disparities in the developmental outcomes of Black and White children in groups A, B, C, and D. Aim 3 will identify proximal and distal childcare and neighborhood factors that contribute to sleep- related racial disparities in the developmental outcomes of Black and White children in groups A, B, C, and D.