Incarceration, Sleep Health, and Cardiovascular Disease Risk

项目摘要 据估计，每年有1100万人从美国监狱和监狱中获释。的个体 有监禁史的人心血管事件和死亡率高于一般人， 特别是在释放后的几周内。在流行病学中，一个特别未被研究的因素是， 心血管疾病是睡眠健康。被监禁的人可能有独特的原因， 在个人、环境和机构政策层面上睡眠不足。他们有更高的 情绪障碍和慢性疼痛，这些都会加剧睡眠不足。暴露在极端温度，噪音， 惩教机构和中途宿舍内的光线可能会影响睡眠。遭受暴力和 监禁条件与心理社会压力或创伤后压力的增加有关 睡眠障碍，导致睡眠中断的噩梦和失眠。本研究的总体目标是 了解监禁，特别是矫正和释放后的社会和物质环境， 导致睡眠不足和心血管疾病的风险。这项研究的中心假设是， 缺乏与监禁期间和之后的社会和物质环境因素有关 release.我提出了一个混合方法的研究，其目的如下：1）确定人群特异性风险因素， 导致监禁期间和之后睡眠不足的社会和物理环境， 改善睡眠健康的潜在机会; 2）使用地理空间分析表征环境 监禁期间和释放后可能导致睡眠不足的因素; 3）开发和试点 评估有监禁史的人的睡眠不足和睡眠环境的工具。到 为了实现这些目标，我将利用正在进行的NHLBI R 01研究的现有基础设施（JUSTICE， 1 R 01 HL 137696 - 01 A1）和SEICHE健康与司法中心的专业知识，耶鲁大学计划在 睡眠医学，睡眠与健康研究计划和行为睡眠医学计划， 亚利桑那大学和国家 环境 环境健康科学研究所（NIEHS）社会和 健康组的决定因素。拟议的研究和培训在睡眠医学和 心脏代谢结果、睡眠健康中的环境因素和干预措施的发展将促进 我作为一名独立研究人员的职业生涯过渡到了睡眠健康差异， 监禁和定位我的研究影响公共卫生干预措施和政策。

PROJECT SUMMARY An estimated eleven million individuals are released from U.S. jails and prisons each year. Individuals with a history of incarceration have higher rates of cardiovascular events and mortality compared to the general population, especially in the weeks following release. An especially underexplored factor in the epidemiology of cardiovascular disease in this population is sleep health. Incarcerated people may have unique reasons for being sleep deficient at the individual, environmental, and institutional policy levels. They have higher rates of mood disorders and chronic pain, which amplify sleep deficiency. Exposure to extreme temperatures, noise, and light within correctional facilities and halfway houses may impact sleep. Exposure to violence and the conditions of confinement are associated with increased rates of psychosocial stress or post-traumatic stress disorder, contributing to sleep-disrupting nightmares and insomnia. The overarching aim of this study is to understand how incarceration, especially correctional and post-release social and physical environments, contribute to sleep deficiency and cardiovascular disease risk. The central hypothesis of this study is that sleep deficiency is associated with the factors in the social and physical environment during incarceration and after release. I propose a mixed methods study with the following aims: 1) Identify population-specific risk factors in the social and physical environment that contribute to sleep deficiency during and after incarceration and potential opportunities to improve sleep health; 2) Characterize using geospatial analysis the environmental factors during incarceration and post-release that may contribute to sleep deficiencies; 3) Develop and pilot instruments to assess sleep deficiency and sleep environment among people with a history of incarceration. To achieve these aims, I will leverage the existing infrastructure of an ongoing NHLBI R01 study (JUSTICE, 1R01HL137696-01A1) and the expertise of the SEICHE Center for Health and Justice, the Yale Program in Sleep Medicine, the Sleep and Health Research Program and Behavioral Sleep Medicine Program at the University of Arizona, and the National Environmental Institute of Environmental Health Sciences (NIEHS) Social and Determinants of Health Group.The proposed research and training in sleep medicine and cardiometabolic outcomes, environmental factors in sleep health, and intervention development will facilitate my transition to a career as an independent researcher in sleep health disparities among people with a history of incarceration and position my research to impact public health interventions and policies.