Sleep Disturbances and Long-term Outcomes after Critical Illness in Children

项目总结 美国每年有250,000名危重儿童被送往350个儿科重症监护病房(ICU) 各州。大多数人(97%)存活下来，但许多危重疾病幸存者长期健康状况良好。 导致生活质量(HRQL)降低和医疗保健使用量增加的损害。急性睡眠不足是 危重疾病后常见。然而，关于睡眠不足的潜在影响的知识有限 关于危重疾病后的健康标志，如身心健康、HRQL或健康服务 利用率。因此，这项提案的主要目标是首次系统地记录 睡眠不足对危重患儿健康、生活质量和卫生保健利用的影响 生病了。核心假设是睡眠不足持续存在并对健康造成负面影响，紧随其后 生病了。候选人。Cornelius Groenewald博士是麻醉学系的助理教授 华盛顿大学和西雅图儿童医院的止痛药。在联合国的支持下 跨学科的导师团队，这个奖项为他提供了一个无与伦比的机会来发展独特的技能 对患有危重疾病的儿童进行睡眠研究。通过培训计划，应聘者将获得 1)睡眠医学和生理学方面的专门培训，2)评估儿童睡眠的活动监测， 3)儿童数字健康干预4)定性和混合方法研究，5)研究设计和 纵向研究和临床试验的统计方法，以及6)赠款写作中的经验学习。 研究。研究计划包括两项研究：1)采用客观和主观相结合的前瞻性队列研究 危重儿童和对照儿童12个月以上的睡眠测量(80=危重疾病，40=年龄和 性别匹配对照)(研究1)和2)定性研究，以了解儿童和父母对 危重疾病后睡眠不足的处理(研究2)。主要目的是1)描述自然的特征， 危重疾病后儿童睡眠不足的轨迹和影响(研究1)，2)确定 危重病后儿童持续睡眠不足12个月以上的危险因素 (研究1)和3)直接从儿童及其父母的角度，确定对以下方面的障碍和促进者的看法 实施干预措施以管理危重疾病后的睡眠不足(研究2)。这两种技术的结合 强大的指导团队、专业的职业发展培训和拟议的研究项目将使 Groenewald博士需要获得开发两个研究流所需的专业知识：1)R01多站点， 旨在确定危重疾病后睡眠障碍潜在机制的观察性研究， 和2)一项R21试点试验，以测试技术提供的睡眠自我管理干预在幸存儿童中的作用 得了重病。

PROJECT SUMMARY Annually 250,000 critically ill children are admitted to 350 pediatric intensive care units (ICUs) in the United States. Most (>97%) survive, however many critical illness survivors suffer significant long-term health impairments that result in lower quality of life (HRQL) and increased health care use. Acute sleep deficiency is common following critical illness. However, limited knowledge exists of the potential impact of deficient sleep on markers of health following critical illness such as physical and mental health, HRQL, or health services utilization. Thus, the primary objective of this proposal is to systematically document for the first time the impact of sleep deficiency on health, quality of life, and health care utilization in children surviving critical illness. The central hypothesis is that sleep deficiency persist and negatively impact health following critical illness. Candidate. Dr. Cornelius Groenewald is an Assistant Professor in the Department of Anesthesiology and Pain Medicine at the University of Washington and Seattle Children’s Hospital. With the support of an interdisciplinary team of mentors, this award provides him an unparalleled opportunity to develop a unique skill set in sleep research in children with critical illness. Through the training plan the candidate will obtain specialized training in 1) sleep medicine and physiology, 2) actigraphy monitoring to assess sleep in children, 3) digital health interventions with children 4) qualitative and mixed-methods research, 5) research design and statistical methods for longitudinal research and clinical trials, and 6) experiential learning in grant writing. Research. The research plan involves 2 studies: 1) a prospective cohort study using objective and subjective measures of sleep over 12 months in children with critical illness and controls (80=critically ill and 40=age and sex matched controls)(study 1), and 2) a qualitative study to understand child and parent perspectives on managing sleep deficiency following critical illness (study 2). Primary aims are to 1) characterize the nature, trajectories, and impact of sleep deficiency experienced by children following critical illness (study 1), 2) identify risk factors associated with persistent sleep deficiency over 12 months in children following critical illness (study 1), and 3) identify, directly from children and their parents, perspectives on the barriers and facilitators of implementing interventions to manage sleep deficiency following critical illness (study 2). The combination of strong mentorship team, specialized career development training, and proposed research projects will allow Dr. Groenewald to gain the expertise needed to develop two streams of research: 1) an R01 multisite, observational study aimed at determining mechanisms underlying sleep disturbances following critical illness, and 2) a R21 pilot trial to test a technology-delivered sleep self-management intervention in children surviving critical illness.