Circadian and sleep mechanisms among racial groups for nicotine dependence, craving, and withdrawal

项目摘要 世界上第一大可预防的死亡原因是烟草使用。尤其是吸烟， 估计有3000亿美元是由于医疗保健和生产力损失造成的。尽管类似的吸烟 尽管吸烟的患病率很高，但与白人相比，黑人遭受的吸烟相关危害不成比例。睡眠 差异，如缩短睡眠时间，缩短昼夜节律周期，更早的时钟型，并增加 据报道，与白人相比，黑人的睡眠时间变化更频繁。鉴于穷人 睡眠质量预测戒烟计划的复发，特别是在社会经济方面 弱势成年人，睡眠不足和不规律的睡眠时间可能会影响吸烟的渴望， 戒断症状在一天的24小时内。令人惊讶的是，很少有研究调查这些 吸烟和渴望的时间模式，而没有关于睡眠中断，时钟类型或种族 差距。更好地理解这些因素可以解释吸烟人群中的异质性， 尤其是少数民族。因此，本提案的目的是检验中心假设，即 吸烟、吸烟依赖、冲动/渴望和戒断与睡眠障碍的关系 取决于种族。三个具体目标将决定：睡眠时间和睡眠质量和数量的贡献 吸烟状况（目标1）、客观睡眠特征和吸烟行为的种族差异 吸烟的黑人和白人（目标2），以及睡眠限制是否会改变烟瘾和戒断症状 不同种族的吸烟者（目标3）。具体来说，我们将利用自我报告问卷，客观的措施， 睡眠质量和时间（活动记录）和昼夜节律阶段（暗光褪黑激素开始），以及生态 瞬时评估香烟使用、吸烟欲望、渴望和戒断症状，以确定昼夜节律 睡眠特征与吸烟状况、吸烟严重程度和 黑人和白人之间的依赖。最后，我们将测试是否急性睡眠限制（4小时的时间， 床）与睡眠延长（10小时的床上时间）相比， 黑人和白色吸烟者戒烟。如果成功，这项研究的结果将导致识别昼夜节律 功能障碍和睡眠不足是睡眠和吸烟之间联系的基础机制 不同人群的吸烟行为和依赖性。此外，这些发现可能会提供信息， 睡眠和睡眠时间对吸烟行为和依赖性的重要性， 帮助制定新的干预措施，以减少烟草使用造成的发病率和死亡率。

PROJECT SUMMARY The number one preventable cause of death in the world is tobacco use. Cigarette smoking in particular, costs an estimated $300 billion due to expenses related to medical care and lost productivity. Despite similar smoking prevalence rates, Blacks suffer disproportionately from smoking-related harms compared to Whites. Sleep disparities such as shortened sleep duration, shorter circadian periodicity, earlier chronotype, and increased variability of sleep timing have been reported more frequently in Blacks compared to Whites. Given that poor sleep quality predicts relapse from smoking cessation programs, particularly among socioeconomically disadvantaged adults, sleep deficiencies and irregular timing of sleep may impact smoking craving and withdrawal symptoms over the course of the 24-hour day. Surprisingly, few studies have examined these temporal patterns of smoking and craving, and none with regard to sleep disruption, chronotype or racial disparities. A better understanding of these factors may explain heterogeneity within the smoking population, especially in minorities. Thus, the purpose of this proposal is to test the central hypothesis that the impact of chronotype and impaired sleep on cigarette usage as well as smoking dependence, urge/craving, and withdrawal depends on race. Three specific aims will determine: contributions of sleep timing and sleep quality and quantity to racial disparities in smoking status (Aim 1), objective sleep characteristics and smoking behavior among blacks and whites who smoke cigarettes (Aim 2), and whether sleep restriction modifies craving and withdrawal in racially diverse smokers (Aim 3). Specifically, we will utilize self-report questionnaires, objective measures of sleep quality and timing (actigraphy) and circadian phase (dim light melatonin onset), as well as ecological momentary assessment of cigarette use, smoking urges, cravings, and withdrawal symptoms to identify circadian and sleep characteristics that are most strongly associated with smoking status, heaviness of smoking and dependence among blacks and whites. Finally, we will test whether acute sleep restriction (4 hours of time-in- bed) versus sleep extension (10 hours of time-in-bed) modifies craving and withdrawal symptoms following cessation in black and white smokers. If successful, the results of this study will result in identification of circadian dysfunction and insufficient sleep as mechanisms that underlie the association between sleep and cigarette smoking behaviors and dependence in diverse populations. Moreover, these findings are likely to inform clinicians of the importance of sleep and sleep timing on cigarette smoking behaviors and dependence that will help in the development of novel interventions to reduce morbidity and mortality caused by tobacco use.