SLEEP AND BEHAVIOR IN SCHOOLCHILDREN

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 欺凌和攻击性行为是小学生中常见的问题，通常对肇事者和受害者都有心理健康后果。欺凌的神经生物学基础几乎没有得到研究，但心理测试和大脑活动成像表明，大脑前部称为前额叶皮层的大片区域功能障碍。在患有睡眠障碍的儿童中也观察到了无抑制、冲动、多动和攻击性行为以及前额叶皮质功能障碍，特别是睡眠呼吸障碍（SDB），如阻塞性睡眠呼吸暂停。睡眠呼吸障碍在儿童中非常普遍，而且经常无法诊断。在从一般儿科候诊室的父母那里收集的初步数据中，研究人员发现欺凌和SDB症状（如打鼾）之间存在很强的关联。在另一项研究中，他们表明，治疗SDB的儿童的攻击行为有所改善。研究人员现在建议对SDB和学童欺凌行为进行第一次前瞻性研究。具体目标是评估欺凌是否与400名伊普西兰蒂公立学校的2年级、3年级、4年级和5年级学生的SDB症状相关;在25名欺凌者和25名匹配的非欺凌者中进行金标准睡眠和行为评估，并比较两组SDB的证据;并在9-12个月后确定25名欺凌儿童中的一些被诊断为SDB的儿童在进行临床指示的SDB治疗时是否导致行为改善。结果可能会导致一个更明确的，多中心的临床试验，旨在通过识别和治疗高度流行的，但往往不被怀疑的SDB减少城市学校环境中的欺凌。'

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Bullying and aggressive behavior are common problems among elementary schoolchildren and often have mental health consequences for both perpetrators and victims. The neurobiological basis for bullying has received little study, but psychological testing and imaging of brain activity implicate dysfunction within a large area at the front of the brain called the prefrontal cortex. Disinhibited, impulsive, hyperactive, and aggressive behavior with prefrontal cortical dysfunction have also been observed in children with sleep disorders, particularly sleep-disordered breathing (SDB) such as obstructive sleep apnea. Sleep-disordered breathing is both highly prevalent and frequently undiagnosed in children. In preliminary data collected from parents in general pediatric waiting rooms, the investigators found a strong association between bullying and SDB symptoms, such as snoring. In another study they showed that aggressive behavior improves in children treated for SDB. The investigators now propose to perform the first prospective research on SDB and bullying in schoolchildren. Specific aims are to assess whether bullying is associated with SDB symptoms in 400 2nd, 3rd, 4th, and 5th grade students in the Ypsilanti Public Schools; to administer gold-standard sleep and behavioral assessments, in 25 bullies and 25 matched non-bullies, and compare evidence for SDB in the two groups; and to determine 9-12 months later whether diagnosis of SDB in some of the 25 bullying children led to improved behavior when clinically-indicated SDB treatment had been pursued. Results could lead to a more definitive, multi-center clinical trial aimed at reduction of bullying in urban school settings through identification and treatment of highly prevalent but often unsuspected SDB.'