SLEEP AND BEHAVIOR IN SCHOOLCHILDREN

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 欺凌和攻击性行为是小学生中常见的问题，往往会对肇事者和受害者产生心理健康后果。欺凌行为的神经生物学基础几乎没有得到研究，但心理测试和对大脑活动的成像表明，大脑前部称为前额叶皮质的一大片区域存在功能障碍。失禁、冲动、多动和攻击性行为伴前额叶皮质功能障碍也在睡眠障碍儿童中观察到，特别是睡眠障碍呼吸(SDB)，如阻塞性睡眠呼吸暂停。睡眠障碍呼吸在儿童中非常普遍，而且经常没有得到诊断。在从普通儿科候诊室的父母那里收集的初步数据中，调查人员发现欺凌和打呼噜等SDB症状之间存在强烈的关联。在另一项研究中，他们表明，接受SDB治疗的儿童攻击性行为有所改善。研究人员现在提议进行第一项关于性侵犯和学龄儿童欺凌行为的前瞻性研究。具体目的是评估Ypsilanti公立学校400名2年级、3年级、4年级和5年级学生的欺凌行为是否与SDB症状有关；对25名欺凌弱者和25名匹配的非欺凌儿童进行黄金标准的睡眠和行为评估，并比较两组中SDB的证据；以及9-12个月后，确定25名欺凌儿童中的一些儿童在接受临床指示的SDB治疗后，被诊断为SDB是否导致行为改善。结果可能会导致一项更明确的、多中心的临床试验，旨在通过识别和治疗高度流行但往往没有可疑的SDB来减少城市学校环境中的欺凌行为。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Bullying and aggressive behavior are common problems among elementary schoolchildren and often have mental health consequences for both perpetrators and victims. The neurobiological basis for bullying has received little study, but psychological testing and imaging of brain activity implicate dysfunction within a large area at the front of the brain called the prefrontal cortex. Disinhibited, impulsive, hyperactive, and aggressive behavior with prefrontal cortical dysfunction have also been observed in children with sleep disorders, particularly sleep-disordered breathing (SDB) such as obstructive sleep apnea. Sleep-disordered breathing is both highly prevalent and frequently undiagnosed in children. In preliminary data collected from parents in general pediatric waiting rooms, the investigators found a strong association between bullying and SDB symptoms, such as snoring. In another study they showed that aggressive behavior improves in children treated for SDB. The investigators now propose to perform the first prospective research on SDB and bullying in schoolchildren. Specific aims are to assess whether bullying is associated with SDB symptoms in 400 2nd, 3rd, 4th, and 5th grade students in the Ypsilanti Public Schools; to administer gold-standard sleep and behavioral assessments, in 25 bullies and 25 matched non-bullies, and compare evidence for SDB in the two groups; and to determine 9-12 months later whether diagnosis of SDB in some of the 25 bullying children led to improved behavior when clinically-indicated SDB treatment had been pursued. Results could lead to a more definitive, multi-center clinical trial aimed at reduction of bullying in urban school settings through identification and treatment of highly prevalent but often unsuspected SDB.'