Disparities in Sleep, Asthma, and the Sleep Context in Urban Children

城市儿童睡眠、哮喘和睡眠环境的差异

• 批准号: 10612495
• 负责人: Mary A Carskadon
• 金额: $ 23.16万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-24 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10612495
• 关键词: 9 year old; Address; Affect; African American; Age; Allergens; Area; Arousal; Asthma; Beds; Behavioral; Belief; Biological; Caregivers; Child; Childhood; Clinical; Crowding; Enrollment; Ethnic Origin; Ethnic group; Exposure to; Family; Fright; Future; Health; Home; Immunologic Markers; Intervention; Interview; Irritants; Latino; Length; Light; Link; Location; Maintenance; Measurement; Measures; Melatonin; Methods; Monitor; Morbidity - disease rate; Neighborhoods; Outcome; Patient Self-Report; Pharmaceutical Preparations; Phase; Polysomnography; Protocols documentation; Qualitative Methods; Reporting; Research; Resources; Risk; Role; Saliva; Sampling; School-Age Population; Sleep; Sleep disturbances; Spirometry; Stress; Symptoms; Time; Walking; Work; actigraphy; base; circadian; circadian biology; cytokine; elementary school; ethnic difference; ethnic minority; experience; health disparity; high risk population; improved; minority children; peer; poor sleep; primary caregiver; pulmonary function; sleep behavior; sleep health; sleep pattern; sleep position; sleep quality; stressor; urban children; urban poverty; urban setting

Project Summary / Abstract Pediatric health disparities in the areas of asthma and sleep persist; asthma and poor sleep outcomes are prevalent among ethnic minority and urban children. Known stressors of urban poverty and poorly controlled asthma can adversely impact the sleep health of urban children with asthma. Our work with urban children with persistent asthma has shown that Latino and African American (AA) children are exposed to sociocontextual (e.g., neighborhood stress, allergens/irritants) and cultural (e.g., acculturative stress) risks that challenge asthma management and increase asthma morbidity. Further, our recently completed study indicates real-time links among asthma, sleep quality, and daytime functioning in urban children. The roles of sleep context, daily sleep routines, and sleep behaviors of urban children of specific ethnic groups are unknown. Our work has focused on contributors to asthma health disparities, assessing sleep quality in this group with actigraphy and self-report sleep behavior measures. Cultural, sleep, and asthma-specific factors in children's sleep contexts can affect children's maintenance of healthy sleep behaviors, and in turn, asthma morbidity. Sleep timing and circadian measures have not been assessed in these groups. Targeting the sleep setting and sleep behaviors along with biological measures of underlying circadian timing in urban children with asthma has the potential to identify mechanisms to inform interventions to improve sleep and asthma outcomes. We propose to utilize a multi-method, in-depth approach to characterize the sleep patterns and sleep settings of urban children in combination with biological measures that may differ based on children's ethnic group background and may contribute to asthma outcomes. We will enroll 240 urban children (ages 7-9, from Latino, AA, and Non-Latino White backgrounds) with persistent asthma and their primary caregivers. Each child/caregiver will participate in a 16- day protocol involving an assessment of the child's sleep context, sleep status (by actigraphy; ambulatory polysomnography, PSG; saliva for dim light melatonin onset, DLMO), and asthma status (lung function by home spirometry, immune biomarker assessment, report of symptoms/control). The sleep context will be examined through our environmental walk-through assessment, in-depth caregiver/child interviews, and self-report assessments, and objective measurement of light during monitoring. The first aim of the study is to examine ethnic differences in sleep patterns, with a focus on such outcomes as timing (e.g., night-to-night variability in time to bed), continuity (e.g., nighttime arousals), and length (sleep duration) measured across 16 days with actigraphy, as well as circadian phase (DLMO) and alignment of sleep timing to circadian phase. The second aim involves examining ethnic differences in the co- occurrence of sleep status and asthma status. The third aim will identify sleep-related (e.g., sleep disruptors), asthma (e.g., availability/location of rescue medication), and cultural-related (e.g., sleep beliefs) risk and resource factors of children's sleep context that moderate associations between sleep and asthma outcomes.

项目摘要 /摘要 哮喘和睡眠地区的小儿健康差异持续存在；哮喘和睡眠不良的结局是 在少数民族和城市儿童中普遍存在。城市贫困和控制不佳的已知压力源 哮喘会对哮喘的城市儿童的睡眠健康产生不利影响。我们与城市儿童的合作 持续性哮喘表明，拉丁裔和非裔美国人（AA）儿童暴露于社会上下文 （例如，邻里压力，过敏原/刺激物）和文化（例如，适应性压力）风险挑战 哮喘管理并增加哮喘发病率。此外，我们最近完成的研究表明实时 哮喘，睡眠质量和白天在城市儿童中的联系。睡眠环境的作用，每天 特定种族的城市儿童的睡眠习惯和睡眠行为尚不清楚。我们的工作有 专注于哮喘健康差异的贡献者，通过艺术学和该群体的睡眠质量和 自我报告睡眠行为措施。儿童睡眠环境中的文化，睡眠和哮喘特异性因素 可能会影响儿童维持健康的睡眠行为，进而影响哮​​喘发病率。睡眠时间和 在这些组中尚未评估昼夜节律措施。针对睡眠环境和睡眠行为 除了哮喘城市儿童中基本昼夜节律时机的生物学措施外，还具有潜力 确定机制以告知干预措施以改善睡眠和哮喘结局。 我们建议利用多方法，深入的方法来表征睡眠方式和睡眠 城市儿童的环境与生物学措施相结合，这些措施可能会根据儿童的种族而有所不同 小组背景，可能有助于哮喘结局。我们将注册240名城市儿童（7-9岁，来自 拉丁裔，AA和非Latino白色背景）具有持续的哮喘及其主要护理人员。每个 儿童/照顾者将参加16天的协议，涉及对儿童睡眠环境的评估，睡眠 状态（通过Actraphy; ABSURATON OLYMNOGRAGY，PSG；用于昏暗的褪黑激素发作的唾液，DLMO）和 哮喘状况（家庭肺活量测定法，免疫生物标志物评估，症状/控制报告）。 睡眠环境将通过我们的环境练习评估进行检查，深入 护理人员/儿童访谈，自我报告评估以及监测过程中光的客观测量。 该研究的第一个目的是检查睡眠模式的种族差异，重点是 结果作为时机（例如，睡觉的夜间到晚上的变化），连续性（例如，夜间唤醒）和 长度（睡眠持续时间）在16天内通过Actraphy和昼夜节律（DLMO）和 睡眠时间与昼夜节律的比对。第二个目的涉及研究共同的种族差异 睡眠状况和哮喘状况的发生。第三个目标将确定与睡眠有关的（例如睡眠破坏者）， 哮喘（例如，救援药物的可用性/位置）和与文化有关的（例如睡眠信念）风险和 儿童睡眠环境的资源因素，使睡眠与哮喘结局之间的关联适度。