Disrupted Sleep in Somali Americans – Implications for Hypertension Risk

睡眠中断是一个主要的公共卫生问题，独立增加心血管疾病的风险 （CVD）。黑人睡眠不足的比例增加，这可能是报告不足。重要的是这些 数据主要涉及西非血统的人。我们目前对黑人睡眠中断的了解， 在范围上已经受到严重限制，不能轻易适用于索马里裔美国人。大多数索马里人 移民已经在明尼苏达州定居，使我们的明尼苏达州的研究团队处于一个独特的位置， 全面研究睡眠中断的机制和后果，作为心血管疾病的介质， 这一人群的健康状况。我们的初步数据显示索马里裔美国人 睡眠中断，这可能会增加他们患高血压和其他心血管疾病的风险。底层 社会文化、行为、环境和生物因素可能导致睡眠风险增加 缺陷因此，我们提出了一个跨学科的方法，使用社会生态模型 国家少数民族健康和健康差异研究所（NIMHD） 框架，以确定未诊断的睡眠不足的类型和严重性，否则健康 索马里裔美国人，确定机制，促进他们的睡眠中断，并检查的作用， 睡眠不足会导致血压升高（BP）。我们的中心假设是，索马里裔美国人将 睡眠不足的可能性很高，部分归因于独特的多层次的个人，心理社会， 环境和行为因素，产生有害的生物学影响。我们提出以下目标： 目的1：确定以前未诊断的睡眠不足的类型和严重程度， 健康的索马里裔美国人假设1：索马里裔美国人有很高（> 50%）的可能性，以前 未确诊的睡眠不足（睡眠不足（<6小时）、失眠和阻塞性睡眠呼吸暂停）。 目标2：应用NIMHD研究框架来定义心理社会，行为，环境和 索马里裔美国人睡眠不足的生物学机制假设2：唯一 多层次的个人、文化和环境风险和保护因素在 调解索马里裔美国人睡眠中断的可能性增加。 目的3：研究索马里裔美国人睡眠不足和血压升高之间的关系。 假设3：在睡眠中断的受试者中，清醒和/或睡眠期间的血压将增加， 与睡眠不足的类型和严重程度相称，并受性别和年龄等因素的影响。 这一建议的预期成果将是一个机械途径，包括NIMHD研究 识别介导睡眠不足的心理社会、行为、环境和生物因素的框架 和相关的血压升高，从而导致高血压风险， 在索马里裔美国人中，对睡眠相关的健康差异及其后果的理解存在差距。

Disrupted sleep, a major public health issue, independently increases risk for cardiovascular disease (CVD). Blacks have increased rates of sleep deficiency, which are likely under-reported. Importantly, these data relate primarily to those of West African ancestry. Our current knowledge of sleep disruption in Blacks, already severely limited in scope, cannot be readily applied to Somali Americans. The majority of Somali immigrants have settled in Minnesota, placing our Minnesota-based research team in a unique position to comprehensively study the mechanisms and consequences of disrupted sleep as a mediator of cardiovascular health disparities in this population. Our preliminary data suggest that Somali Americans have a high likelihood of disrupted sleep, which may put them at increased risk for hypertension and other CVD. Underlying sociocultural, behavioral, environmental and biological factors likely contribute to an increased risk for sleep deficiencies. We therefore propose an inter-disciplinary approach using a socioecological model informed by the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to determine the types and severity of undiagnosed sleep deficiencies in otherwise healthy Somali Americans, identify mechanisms contributing to their disrupted sleep, and examine the role of sleep deficiencies in raising blood pressure (BP). Our central hypothesis is that Somali Americans will have a high likelihood of sleep deficiencies attributable in part to unique multilevel individual, psychosocial, contextual and behavioral factors, which exert deleterious biological effects. We propose the following aims: Aim 1: Determine the types and severity of previously undiagnosed sleep deficiencies in otherwise healthy Somali Americans. Hypothesis 1: Somali Americans have a high (>50%) likelihood of previously undiagnosed sleep deficiencies (short sleep (<6 hours), insomnia and obstructive sleep apnea). Aim 2: Apply the NIMHD Research Framework to define psychosocial, behavioral, environmental and biological mechanisms mediating sleep deficiencies in Somali Americans. Hypothesis 2: Unique multilevel individual, cultural and environmental risk and protective factors play a mechanistic role in mediating an increased likelihood of disrupted sleep in Somali Americans. Aim 3: Examine the relationship between sleep deficiencies and increased BP in Somali Americans. Hypothesis 3: BP during wakefulness and/or sleep will be increased in those subjects with disrupted sleep, commensurate with type and severity of sleep deficiency, and moderated by factors such as sex and age. The expected outcome of this proposal will be a mechanistic pathway incorporating the NIMHD Research Framework to identify psychosocial, behavioral, contextual and biological factors mediating sleep deficiencies and related increases in BP, and consequently hypertension risk, thus addressing important knowledge gaps in understanding sleep-related health disparities and their consequences in Somali Americans.