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

项目概要/摘要 迫切需要解决儿童早期睡眠健康差异，因为睡眠不足 不成比例地影响种族/民族少数民族儿童，并对关键的神经行为产生负面影响。 和社会情感的发展。两种常见的儿童早期睡眠不足与不良反应有关 结果是（1）睡眠呼吸障碍（SDB），其范围从打鼾到严重阻塞性睡眠 呼吸暂停（OSA），和（2）睡眠不足，或睡眠少于基于年龄的24小时睡眠指南。相比 与非拉丁裔白色（以下简称“白人”）青年相比，非拉丁裔黑人/非裔美国人（以下简称“黑人”）青年是其4-6倍 更有可能经历SDB，也更有可能经历短睡眠时间。深发展和 睡眠不足也常常同时发生在幼儿身上。种族差异的机制 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多层次的干预措施， 社会生态因素，以减少常见的，共同发生的 学龄前儿童睡眠健康的种族差异。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和睡眠不足的社会经济差异有据可查，家庭因素包括照顾者 压力、健康知识和工作时间表很少被考虑。很少有研究检查其他可改变的 家庭因素，如睡前常规，睡前电子产品和育儿实践，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，个人持续 黑人家庭面临的中介和结构性种族主义，教师的种族偏见，儿童保育质量， 邻里特征很可能是造成这些差异的原因，但研究不足。解决这些 这项工作的目标是：（1）审查种族差距， 儿童早期SDB和/或睡眠不足的神经行为和社会情感影响，以及（2）识别 近端和远端社会生态因素与睡眠相关结果的种族差异有关。黑色 和白色3-5岁的儿童将被招募（A）SD B仅，（B）睡眠不足，（C）SD B和睡眠不足 睡眠，和（D）匹配的健康对照，以检查以下目标，使用多方法，多信息 方法与照顾者和教师记者，观察任务，定性方法。目标1将 比较神经行为（执行功能，注意力，警惕性）和社会情感功能（社会 技能，情绪调节）。目标2将确定可改变的家庭因素， A、B、C组中黑人和白色儿童发育结果中与睡眠相关的种族差异， 和D.目标3将确定近端和远端儿童保育和邻里因素，有助于睡眠- A、B、C和D组中黑人和白色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.