Sleep and Child Developmental Outcomes: Physiological and Contextual Influences

描述（由申请人提供）：美国儿童的睡眠剥夺是一个全国性的问题。估计有睡眠障碍的儿童在20%到40%之间。行为问题、消极情绪、神经行为障碍和学习成绩不佳都与儿童睡眠障碍有关。然而，这项研究的重大空白包括将睡眠障碍与认知功能和身心健康问题的发展轨迹联系起来的纵向研究；生理系统的测试，作为机制运作，增加脆弱性或提供保护，以防止睡眠障碍；以及对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)研究睡眠参数（睡眠量、睡眠质量、睡眠时间）与心理健康、身体健康和认知/学业成绩的发展轨迹之间的联系；(2)研究迷走神经张力或迷走神经抑制介导或调节睡眠障碍与发育结果之间关系的多系统过程；(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态而不同。纵向设计将包括4波数据收集，每波之间有一年的滞后。样本将包括320名8-10岁的儿童（50%为女孩），其中大部分来自低社会经济地位和非洲裔美国家庭。通过活动记录仪客观评估睡眠参数，通过儿童和家长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。孩子的适应和健康状况将通过家长、孩子和老师的报告进行评估。认知能力和成就将通过标准化测试和成绩进行评估。拟议的研究将通过研究加剧或减轻睡眠障碍影响的生理反应，以及通过检查公共卫生优先事项作为结果，如体重指数、身体健康和疾病以及学习成绩，促进对与睡眠障碍相关的儿童结果的理解（PA-07-140，睡眠和睡眠障碍研究）。此外，通过利用正常发育儿童的样本，拟议的研究将在广泛的社会生态风险水平上调查睡眠过程，从而允许根据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，本研究将关注这些过程如何随着时间的推移而展开。研究结果将阐明睡眠障碍的具体形式和时间，这些障碍会增加儿童期负面结果的风险，有助于确定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。与公共健康相关：睡眠障碍在美国儿童中非常普遍，越来越多的研究表明，睡眠障碍对儿童功能的多个领域都有有害影响。然而，在知识方面的重大差距包括将睡眠障碍与认知功能和身心健康问题的发展轨迹联系起来的纵向证据；生理系统的测试，作为机制运作，增加脆弱性，或提供保护，以防止睡眠障碍；以及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。这项研究的发现将阐明睡眠障碍的具体形式和时间，这些障碍会增加儿童时期负面结果的风险，有助于确定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.