Effects of a behavioral sleep extension intervention on cardiometabolic risk factors among patients with elevated BP/hypertension

项目总结/摘要 在美国，每两个成年人中就有一个人患有至少一种心脏代谢疾病（CMD），包括高血压、心脏病、 糖尿病或中风。尽管睡眠时间短与心脏代谢健康之间存在联系， 研究试图通过延长睡眠来改善CMD风险。一个很有前途的研究领域是睡眠延长 干预措施。到目前为止，一些小型研究已经证明了睡眠和CMD的短期改善 风险因素，如血压和血糖控制。然而，这些研究受到其短 长期设计和观察睡眠延长作为一个实验操作，而不是一个可持续的行为 变化在这项研究中，我们建议进行一项随机对照试验，以测试我们的行为睡眠 与健康教育对照组相比， 患有高血压前期/I期高血压的成人。睡眠延长干预是基于3个良好的 建立行为改变原则：自我监测（可穿戴睡眠跟踪器），教育（电子邮件内容） 和激励增强（简短的电话辅导）。在这12个月的研究中，我们将包括一个 干预期（第1-8周，每周干预一次），维持期（第2-6个月，每月干预一次） 随访期（无干预）。这项研究的主要结果将是睡眠时间和主要的 次要结果将是24小时动态血压监测，这使我们能够评估两者 日常生活中的日间和夜间血压。12个月睡眠时间变化的评价 将使我们能够测试我们的行为睡眠延长干预对急性和持续性睡眠的有效性。 睡眠持续时间和CMD风险因素以及重要的心理，行为和 生理介质如自我报告的嗜睡、BMI、饮食、体力活动、血糖控制和 炎症这项研究的成功完成将提供有关影响的关键信息， 行为睡眠扩展对健康和生活质量的重要措施，需要纳入睡眠 扩展到CMD风险干预，如饮食和体育活动计划。长期目标是 研究是开发，测试和传播有效的和可扩展的睡眠干预措施，以减少慢性 疾病风险和改善疾病管理。

PROJECT SUMMARY/ABSTRACT One in two adults in the U.S. have at least one cardiometabolic disease (CMD) including hypertension, heart disease diabetes or stroke. Despite links between short sleep duration and cardiometabolic health, few studies have sought to improve CMD risk by extending sleep. A promising area of research is sleep extension interventions. To date, several small studies have demonstrated short term improvements in sleep and CMD risk factors such as blood pressure and glycemic control. However, these studies are limited by their short term design and viewing sleep extension as an experimental manipulation rather than a sustainable behavior change. In this study, we are proposing to conduct a randomized controlled trial to test our behavioral sleep extension intervention compared to a health education control group on sleep and CMD risk factors among adults with prehypertension/stage I hypertension. The sleep extension intervention is based on 3 well established behavior change principles: self-monitoring (wearable sleep tracker), education (email content) and motivational enhancement (brief telephone coaching). During this 12 month study, we will include an intervention period (weeks 1-8, weekly intervention), maintenance period (months 2-6, monthly intervention) and follow-up period (no intervention). The primary outcome for this study will be sleep duration and the main secondary outcome will be 24-h ambulatory blood pressure monitoring, which allows us to evaluate both daytime and nighttime blood pressures in daily life. The evaluation of sleep duration changes of 12-months will allow us to test the efficacy of our behavioral sleep extension intervention on acute and sustained changes in sleep duration and CMD risk factors as well as important psychological, behavioral and physiological mediators such as self-reported sleepiness, BMI, diet, physical activity, glycemic control and inflammation. Successful completion of this study will provide critical information about the impact of behavioral sleep extension on important measures of health and quality of life needed to incorporate sleep extension into CMD risk interventions, such as diet and physical activity programs. The long-term goal of this research is to develop, test and disseminate effective and scalable sleep interventions to reduce chronic disease risk and improve disease management.