Sleep and Child Developmental Outcomes: Physiological and Contextual Influences

描述(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，患有睡眠障碍的儿童比例在20%到40%之间。行为问题、消极情绪、神经行为障碍和学业不良都与儿童睡眠障碍有关。然而，这项研究中的重大空白包括将睡眠障碍与认知功能和心理和身体健康问题的发育轨迹联系起来的纵向研究；对作为机制运行、增加脆弱性或提供睡眠障碍保护的生理系统的测试；以及对儿童经常经历睡眠障碍的种族和社会经济背景的调查。本研究的目的是：(1)检验睡眠参数(数量、质量、时间表)与心理健康、身体健康和认知/学习结果的发展轨迹之间的联系；(2)调查多系统过程，其中睡眠障碍和发展结果之间的联系是通过迷走神经紧张性或迷走神经抑制来调节或调节的；(3)评估这些联系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。纵向设计将包括4个波的数据收集，每个波之间有一年的滞后。样本将包括320名儿童(50%为女孩)，年龄为8-10岁，来自低社会经济地位和非裔美国家庭的比例较高。睡眠参数将通过活动记录仪进行客观评估，并通过儿童和家长报告进行主观评估。完善的程序将评估迷走神经张力和迷走神经抑制以应对实验室挑战。孩子的适应和健康将通过家长、孩子和老师的报告进行评估。认知技能和成绩将通过标准化测试和评分进行评估。这项拟议的研究将通过研究加剧或减弱睡眠障碍影响的生理反应，以及通过检查公共健康优先事项作为结果，如身体质量指数、身体健康和疾病，以及学习成绩(PA-07-046，心身相互作用和健康研究)，促进对与睡眠障碍有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，拟议的研究将调查各种社会生态风险水平的睡眠过程，从而能够对广泛的儿童进行按风险水平进行的适度性测试和推广(PA-07-379，关于了解和减少健康差距的行为和社会科学研究)。最后，这项研究将关注这些过程是如何随着时间的推移而展开的。研究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时期负面后果的风险，有助于识别处于最高风险的儿童和家庭，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，研究越来越多地表明，它们在儿童功能的多个领域都有有害影响。然而，知识方面的重大空白包括：将睡眠障碍与认知功能和心理和身体健康问题的发育轨迹联系起来的纵向证据；对作为机制运行、增加脆弱性或提供保护免受睡眠障碍影响的生理系统的测试；对与性别和青春期有关的影响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的调查。这项拟议的研究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时期负面结果的风险，有助于识别处于最高风险的儿童和家庭，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.