Sleep Disorders in Adults with Sickle Cell Disease: Frequency, Associations with Cardiovascular and Pain Indicators, and Responses to Treatment

镰状细胞病成人睡眠障碍：频率、与心血管和疼痛指标的关联以及对治疗的反应

• 批准号: 10331061
• 负责人: Peter Lefort Whitesell
• 金额: $ 9.29万
• 依托单位: HOWARD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-30 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10331061
• 关键词: Acute Pain; Address; Adult; Adverse effects; Affect; African American population; Anemia; Arousal; Biological Markers; Blood Pressure; Bone necrosis; Breathing; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Clinic; Clinical; Cognitive Therapy; Data; Disease; Drowsiness; Echocardiography; Endothelium; Epidemiology; Event; Frequencies; Functional disorder; General Population; Goals; Hour; Hypertension; Inflammation; Inflammatory; Injury; Intervention; Laboratories; Left Ventricular Function; Life Expectancy; Measures; Medical; Obesity; Obstructive Sleep Apnea; Pain; Pain Measurement; Patient Self-Report; Patients; Physiological; Pilot Projects; Polysomnography; Population; Prevalence; Quality of life; Questionnaires; Recording of previous events; Research; Risk Factors; Role; Sampling; Sensory; Severities; Sickle Cell; Sickle Cell Anemia; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep Disorders; Sleep Fragmentations; Sleep disturbances; Sleeplessness; Snoring; Stroke; Subgroup; Sympathetic Nervous System; Testing; Thrombosis; Universities; Venous; Walking; Work; actigraphy; acute chest syndrome; adverse outcome; burden of illness; cardiovascular disorder risk; central pain; chronic pain; comorbidity; follow-up; functional disability; health disparity; heart rate variability; improved; indexing; minority health disparity; mortality; nocturnal Hypoxemia; pain perception; pain sensitivity; pain symptom; patient population; peripheral pain; positive airway pressure; pulmonary arterial pressure; recruit; response; screening; sleep quality; standard of care; symptomatology; thrombotic; thrombotic complications; treatment effect; treatment response; vaso-occlusive pain

Project Summary This study examines the relationship of sleep disturbance with cardiovascular and pain indicators in patients with sickle cell disease (SCD). Reduced sleep duration and sleep disordered breathing are strongly correlated with hypertension and cardiovascular disease in the general population, and especially in African Americans. In SCD, these adverse effects are anticipated to be further compounded by the sickling of red blood cells and microvascular thrombosis unique to the disease. Despite extensive research currently exploring the physiologic and epidemiologic linkage of sleep and cardiovascular disease in the general population, limited data exist in SCD, particularly in adults. Similarly, while sleep quality is known to affect pain perception in many settings, it is relatively unexplored in SCD. Patients presenting for routine follow-up at the Howard University Sickle Cell Center will be invited to participate in this study. To assess disease burden and functional impairment, they will be carefully characterized regarding medical background including severity of anemia, comorbid disease, and frequency of pain crises. Cardiovascular parameters evaluated will include blood pressure, echocardiography and 6 minute walk distance. Sympathetic nervous system (SNS) activity will be assessed utilizing heart rate variability analysis. Biomarkers of inflammation and endothelial injury will be obtained. Finally, peripheral and central pain sensitivity responses will be evaluated in a subgroup of subjects representing a spectrum of sleep apnea severity using quantitative sensory testing. This detailed characterization of disease burden and functional impairment will be correlated with careful analysis of both subjective and objective measures of sleep duration and sleep disturbance. This will include self-reports of sleep quality and daytime sleepiness, actigraphy determined sleep duration and efficiency, and overnight sleep laboratory polysomnography. The first aim is to assess the prevalence and severity of sleep impairment, namely reduced habitual sleep duration, arousal frequency, sleep apnea, and nocturnal hypoxemia, in a clinic population of patients with SCD recruited without selection for sleep complaints. The second aim is to correlate sleep disorders with indicators of cardiovascular dysfunction and pain. The third aim is to define the response of cardiovascular and pain indicators to the treatment of any identified sleep disorders. Sickle Cell Disease (SCD) affects 1 in 500 African Americans and is associated with cardiovascular complications that degrade quality of life and increase mortality. Sleep apnea, nocturnal hypoxemia, and insufficient sleep promote cardiovascular disease, and preliminary information suggests they are common in SCD. This study assesses the frequency of sleep disorders and the cardiovascular and pain related consequences of these disorders for SCD patients.

项目摘要 这项研究检查了患者的睡眠障碍与心血管和疼痛指标的关系 镰状细胞疾病（SCD）。睡眠持续时间减少和睡眠失调呼吸密切相关 普通人群，尤其是非裔美国人的高血压和心血管疾病。 在SCD中，预计这些不良反应会因红细胞和 疾病独有的微血管血栓形成。尽管目前进行了广泛的研究探索生理学 在普通人群中睡眠和心血管疾病的流行病学联系，存在有限的数据 SCD，特别是在成年人中。同样，尽管已知睡眠质量会影响许多情况下的疼痛感知 在SCD中相对尚未探索。在霍华德大学镰状细胞进行例行跟进的患者 中心将被邀请参加这项研究。为了评估疾病负担和功能障碍，它们 将在医学背景上进行仔细的特征，包括贫血，合并症的严重程度， 和疼痛危机的频率。评估的心血管参数将包括血压， 超声心动图和6分钟步行路程。交感神经系统（SNS）活动将被评估 利用心率变异性分析。将获得炎症和内皮损伤的生物标志物。 最后，将在受试者的子组中评估外周和中心疼痛敏感性反应 使用定量感觉测试代表睡眠呼吸暂停严重程度。这是详细的 疾病负担和功能障碍的表征将与对两者的仔细分析相关 睡眠持续时间和睡眠障碍的主观和客观度量。这将包括 睡眠质量和白天的嗜睡，动作学确定睡眠持续时间和效率，并过夜睡眠 实验室多个学位学。第一个目的是评估睡眠障碍的患病率和严重程度， 诊所中的习惯性睡眠持续时间，唤醒频率，睡眠呼吸暂停和夜间低氧血症减少了 招募SCD患者的人群无需选择睡眠投诉。第二个目的是关联 患有心血管功能障碍和疼痛指标的睡眠障碍。第三个目的是定义响应 对任何已识别的睡眠障碍的治疗的心血管和疼痛指标。镰状细胞性贫血症 （SCD）影响500名非裔美国人中的1个，并且与降解的心血管并发症有关 生活质量和增加死亡率。睡眠呼吸暂停，夜间低氧血症和睡眠不足促进 心血管疾病和初步信息表明它们在SCD中很常见。这项研究评估 睡眠障碍的频率以及这些疾病的心血管和疼痛与疼痛有关的后果 SCD患者。