Sleep and Child Developmental Outcomes: Physiological and Contextual Influences

描述（由申请人提供）：美国儿童睡眠不足是一个国家关注的问题。据估计，有睡眠障碍的儿童占20%到40%。行为问题、消极情绪、神经行为障碍和学业不良与儿童期睡眠障碍有关。然而，这项研究中的重大差距包括将睡眠障碍与认知功能和精神和身体健康问题的发展轨迹联系起来的纵向研究;作为机制运行的生理系统的测试，增加脆弱性或提供对睡眠障碍的保护;以及儿童经常经历睡眠中断的种族和社会经济背景的调查。本研究的目的是：（1）检查睡眠参数之间的联系（2）研究多系统过程，其中睡眠障碍和发育结果之间的关联由迷走神经张力或迷走神经抑制介导或调节;以及（3）评估这些关联和发展过程在多大程度上因种族、社会经济水平、儿童性别和青春期状况而不同。纵向设计将涉及4波数据收集，每波之间有一年的滞后。样本将包括320名儿童（50%为女孩），年龄在T1时为8-10岁，来自低社会经济地位和非洲裔美国人家庭的代表性很高。将通过体动记录仪客观评估睡眠参数，通过儿童和父母报告主观评估睡眠参数。完善的程序将评估迷走神经张力和迷走神经抑制实验室挑战。儿童的适应和健康将与家长，儿童和教师的报告进行评估。认知技能和成就将通过标准化测试和等级进行评估。这项拟议中的研究将促进对与睡眠障碍相关的儿童结局的理解（PA-07-140，睡眠和睡眠障碍研究），通过研究加重或减轻睡眠障碍影响的生理反应，并通过检查作为结果的公共卫生优先事项，如体重指数，身体健康和疾病，以及学业成绩（PA-07-046，身心互动与健康研究）。此外，通过利用正常发育的儿童样本，拟议的研究将调查广泛的社会生态风险水平下的睡眠过程，从而允许通过风险水平进行适度测试，并推广到广泛的儿童（PA-07-379，关于理解和减少健康差异的行为和社会科学研究）。最后，本研究将重点关注这些过程如何随着时间的推移而展开。调查结果将阐明睡眠障碍的具体形式和时间，这些睡眠障碍会增加儿童期负面结果的风险，帮助识别风险最大的儿童和家庭，并揭示预防和干预的行为、生理和生态目标。公共卫生相关性：美国儿童的睡眠障碍非常普遍，研究越来越多地表明其对儿童功能的多个领域的有害影响。然而，在知识方面存在重大差距，包括将睡眠障碍与认知功能和精神和身体健康问题的发展轨迹联系起来的纵向证据;作为机制运行的生理系统的测试，增加脆弱性，或提供对睡眠障碍的保护;以及对性别和青春期相关影响的调查，以及儿童经历睡眠障碍和相关问题的种族和社会经济背景。拟议研究的结果将阐明睡眠障碍的具体形式和时间，这些睡眠障碍会增加儿童期负面结果的风险，有助于识别风险最大的儿童和家庭，并阐明预防和干预的行为，生理和生态目标。

DESCRIPTION (provided by applicant): Sleep deprivation in American children is a matter of national concern. Estimates of children with sleep disturbances range from 20% to 40%. Behavior problems, negative mood, neurobehavioral impairments, and academic underachievement have been associated with childhood sleep disturbances. However, significant gaps in this research include longitudinal studies linking sleep disturbances with developmental trajectories of cognitive functioning and mental and physical health problems; tests of physiological systems that operate as mechanisms, increase vulnerability or provide protection against sleep disturbances; and investigations of the ethnic and socioeconomic context within which children often experience sleep disruptions. The objectives of the present study are to: (1) examine linkages between sleep parameters (amount, quality, schedule) and developmental trajectories of mental health, physical health, and cognitive/academic outcomes; (2) investigate multi-system processes, in which associations between sleep disturbances and developmental outcomes are mediated or moderated by vagal tone or vagal suppression; and (3) evaluate the extent to which these associations and developmental processes operate differently by ethnicity, socioeconomic levels, child gender, and pubertal status. The longitudinal design will involve 4 waves of data collection with a one-year lag between each wave. The sample will consist of 320 children (50% girls), 8-10 years of age at T1, with high representation from low SES and African-American families. Sleep parameters will be assessed objectively, via actigraphy, and subjectively, via child and parent reports. Well-established procedures will assess vagal tone and vagal suppression to laboratory challenges. Children's adjustment and health will be assessed with parent, child, and teacher reports. Cognitive skill and achievement will be assessed via standardized tests and grades. The proposed study will advance understanding of child outcomes associated with sleep disturbances (PA-07-140, Research on Sleep and Sleep Disorders), by studying physiological responses that exacerbate or attenuate the effects of sleep disturbances, and by examining public health priorities as outcomes, such as body mass index, physical health and illness, and academic performance (PA-07-046, Research on Mind-Body Interactions and Health). In addition, by utilizing a sample of normally developing children, the proposed study will investigate sleep processes across a wide range of social-ecological risk levels, thereby allowing tests of moderation by risk level and generalization to a broad range of children (PA-07-379, Behavioral and Social Science Research on Understanding and Reducing Health Disparities). Finally, this research will focus on how these processes unfold over time. Findings will illuminate specific forms and timing of sleep disturbances that elevate risk for negative outcomes in childhood, help identify children and families at greatest risk, and shed light on behavioral, physiological, and ecological targets for prevention and intervention. PUBLIC HEALTH RELEVANCE: Sleep disturbances in American children are highly prevalent, and research increasingly demonstrates their harmful effects across multiple domains of child functioning. However, significant gaps in knowledge include longitudinal evidence linking sleep disturbances with developmental trajectories of cognitive functioning and mental and physical health problems; tests of physiological systems that operate as mechanisms, increase vulnerability, or provide protection against sleep disturbances; and investigations of gender- and puberty- related effects, as well as the ethnic and socioeconomic context within which children experience sleep disturbances and associated problems. Findings of the proposed study will illuminate specific forms and timing of sleep disturbances that elevate risk for negative outcomes in childhood, help identify children and families at greatest risk, and shed light on behavioral, physiological, and ecological targets for prevention and intervention.