Sleep Disordered Breathing and Asthma Morbidity in Inner City School Children

描述(由申请人提供)：哮喘对市中心的儿童影响不成比例。市中心的哮喘发病率可能是多因素的，环境暴露起着关键作用。市中心人群容易受到睡眠障碍的影响；然而，在市中心哮喘患者中，睡眠呼吸紊乱(SDB)与哮喘发病率之间的关系尚未得到彻底的研究。本研究的主要目的是探讨SDB对哮喘发病率的影响。我们假设SDB将独立地与哮喘发病率增加有关。本研究的次要目标是确定家庭和学校环境暴露(包括常见的空气变应原[尘螨、猫、狗、老鼠、蟑螂和霉菌]、内毒素和空气污染[黑碳和二氧化氮])对SDB和哮喘发病率的不同影响。很少有研究考察环境暴露对SDB和哮喘发病率的复杂关联的作用。我们假设，学校基础暴露将独立地促进SDB和哮喘的发病率。这项研究是独一无二的，因为我们将是第一批检查学校/教室特定环境暴露对SDB和哮喘发病率的影响的研究之一。为了验证这些假设，我们将评估在已建立的队列中登记的儿童、市中心学校的过敏原和儿童哮喘(Wanda Phipatanakul博士，Pi，NIAID R-01-AI-073964)的SDB(使用腕部活动描记和脉搏血氧饱和度)。该提案详细介绍了一个为期一年的项目，该项目旨在为赖特博士提供评估环境暴露及其对SDB和哮喘发病率的影响的培训和专业知识，并特别关注市中心哮喘患者的学校环境。赖特博士将在哮喘和环境流行病学专家菲帕塔纳库尔博士的指导下工作，此外还有一支非凡的研究团队，其中包括乔舒亚·博伊斯博士(擅长哮喘)、苏珊·雷德林博士(擅长睡眠医学)和布伦特·库尔博士(擅长环境统计建模)，他们投入了时间和资源来促进赖特博士的职业发展和成功完成拟议的项目。作为研究培训计划的一部分，赖特博士将完成公共卫生硕士学位，主攻环境健康，以便获得必要的流行病学和生物统计学技能，成为一名成功的独立初级研究员。

DESCRIPTION (provided by applicant): Asthma disproportionately affects inner-city children. Asthma morbidity in the inner-city is likely multifactorial with environmental exposures playing a critical role. Inner city populations are vulnerable to sleep disturbances; however, the relationship between sleep disordered breathing (SDB) and asthma morbidity has not been thoroughly investigated in inner city asthmatics. The primary objective of this study is to investigate the effect of SDB on asthma morbidity. We hypothesize that SDB will be independently related to increased asthma morbidity. The secondary objective of this study is to determine the differential effect of home and school environmental exposures (including common aeroallergens [dust mite, cat, dog, mouse, cockroach, and mold], endotoxin, and air pollution [black carbon and nitrogen dioxide]) on SDB and asthma morbidity. There is a paucity of studies that have examined the role of environmental exposures on the complex associations of SDB and asthma morbidity. We hypothesize that school based exposures will independently contribute to SDB and asthma morbidity. This study is unique because we will be among the first to examine the effect of school/classroom specific environmental exposures on SDB and asthma morbidity. To test these hypotheses, we will evaluate the children enrolled in an established cohort, the Allergens in Inner-City Schools and Childhood Asthma (Dr. Wanda Phipatanakul, PI, NIAID R-01-AI-073964), for SDB (using wrist actigraphy and pulse oximetry). This proposal details a one year project to provide Dr. Wright with training and expertise in the assessment of environmental exposures and its effects on SDB and asthma morbidity with a specific focus on the school environment of inner city asthmatics. Dr. Wright will work under the mentorship of Dr. Phipatanakul, an expert in asthma and environmental epidemiology, in addition to an extraordinary team of researchers, including Drs. Joshua Boyce (with expertise in asthma), Susan Redline (with expertise in sleep medicine), and Brent Coull (with expertise in environmental statistical modeling), who have committed their time and resources to facilitate Dr. Wright's career development and the successful completion of the proposed project. As part of the research training program, Dr. Wright will complete a Master of Public Health with a concentration in environmental health in order to acquire the necessary epidemiologic and bio-statistical skills to become a successful independent junior investigator.