Sleep disparities' role in adolescent fatigue and functioning: A mixed-methods study

睡眠差异在青少年疲劳和功能中的作用：一项混合方法研究

• 批准号: 10399637
• 负责人: James Spilsbury
• 金额: $ 65.27万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10399637
• 关键词: Address; Adolescent; Adult; African American; Automobile Driving; Awareness; Caregivers; Cellular Phone; Child; Clinical; Cognitive; Communities; Crime; Crowding; Data; Development; Disadvantaged; Discrimination; Drowsiness; Ecological momentary assessment; Economically Deprived Population; Economics; Environment; Environmental Risk Factor; Family; Family member; Fatigue; Feeling; Frequencies; Health; Home; Household; Individual; Lead; Link; Measures; Mediating; Mediator of activation protein; Methods; Minority; Modeling; Neighborhoods; Noise; Outcome; Pathway interactions; Personal Satisfaction; Prevalence; Qualitative Methods; Quality of life; Race; Reporting; Research; Risk; Role; Sampling; Schedule; Self Management; Shapes; Sleep; Sleep Deprivation; Socioeconomic Status; Stress; Technology; Teenagers; Time; Violence; Work; adolescent health; base; behavioral health; behavioral outcome; caucasian American; design; disadvantaged population; economic disparity; exhaust; experience; falls; functional outcomes; improved; innovation; low socioeconomic status; new technology; novel; organizational structure; people of color; perceived discrimination; poor sleep; racial difference; racial disparity; residence; resilience; sensor technology; sleep behavior; sleep pattern; sleep quality; sleep quantity; smart watch; social; social capital; social cohesion; social organization; socioeconomic disadvantage

Abstract: Fatigue is a frequently reported complaint of adolescents and is linked to a wide range of adverse health, behavioral, and functional outcomes. Disparities in fatigue prevalence exist, with greater frequency seen in minority, economically disadvantaged populations. Disparities in sleep quantity and quality also fall along ethnic and economic lines, with poorer sleep observed among the economically disadvantaged and persons of color. Because of fatigue’s strong link with inadequate sleep, our understanding of fatigue will benefit from greater awareness of its relationship with sleep disparities, especially among early adolescents, when notable racial differences in sleep duration and timing emerge. Numerous social-environmental factors in individual, household, and neighborhood levels may serve as risk and resilience factors shaping disparities in sleep and fatigue. Yet, the relative contributions of these factors are yet unclear. Moreover, the association between inadequate sleep and fatigue is obscured by another common teen complaint: daytime sleepiness. The relationship between fatigue and sleepiness, and their differential effects on adolescent health and functioning are yet unclear. Our study purpose is to identify key mechanisms underlying racial and economic disparities in sleep and their association with fatigue, daytime sleepiness, and functioning in early adolescents. We posit that differences in household organization, socioeconomic disadvantage, and experiences of discrimination are key drivers of sleep disparity between African American and White adolescents. Guided by a community advisory board, and using a novel smart phone/sensor technology developed in our pilot research on adolescent sleep, we propose a home-based study among African American and White adolescents in Cleveland, OH to (a) identify factors responsible for adolescent sleep disparities; (b) determine the effects of sleep disparities on fatigue, daytime sleepiness, and functioning; and (b) disentangle effects of sleepiness from fatigue. Using a mixed-methods design and sample of 350 adolescents and caregivers balanced by race and socio-economic status, we will conduct linear mixed modeling to assess associations between baseline (time-invariant) and nightly (time-varying) measures of key mechanisms with that of sleep quality and quantity, fatigue, sleepiness, and functioning over a 2-week period. A qualitative study component will focus on how household/neighborhood factors and discrimination shape sleep, the teen experience of sleepiness vs. fatigue, and self-management strategies to address problematic sleep and fatigue. The study is innovative: it simultaneously investigates multiple potential mechanisms driving adolescent sleep disparities and uses novel technology to better measure the context of teen sleep. Expected results will be significant: identifying drivers of sleep disparities is vital to improve sleep, reduce fatigue and sleepiness, and improve adolescent health, functioning, and quality of life. Moreover, disentangling fatigue from daytime sleepiness is needed because their clinical implications and treatment differ.

摘要：疲劳是对青少年的经常报告的投诉，与广泛的逆境有关 健康，行为和功能结果。存在疲劳患病率的差异，频率更高 在少数派中，经济上处于弱势群体中。睡眠数量和质量的差异也下降 沿着种族和经济路线，在经济上处于不利地位的人中观察到睡眠较差和 有色人种。由于疲劳与睡眠不足的紧密联系，我们对疲劳的理解将会 对其与睡眠差异的关系的更大认识，尤其是在早期青少年中，受益于 当睡眠持续时间和时机出现明显的种族差异时。许多社会环境因素 个人，家庭和邻里水平可能是塑造分布的风险和弹性因素 睡眠和疲劳。然而，这些因素的相对贡献尚不清楚。而且，协会 另一个常见的青少年抱怨掩盖了睡眠不足和疲劳之间：白天嗜睡。 疲劳与嗜睡之间的关系及其对青少年健康的不同影响 功能尚不清楚。我们的研究目的是确定赛车和 睡眠的经济差异及其与疲劳，白天嗜睡和发挥作用 早期青少年。我们指出，家庭组织，社会经济障碍和 歧视的经历是非裔美国人和白人之间睡眠差异的关键驱动力 青少年。在社区顾问委员会的指导下，并使用新颖的智能手机/传感器技术 在我们关于青少年睡眠的试点研究中开发的，我们建议非洲的家庭研究 俄亥俄州克利夫兰市的美国和白人青少年（a）确定负责青少年睡眠的因素 差异； （b）确定睡眠差异对疲劳，白天嗜睡和功能的影响；和 （b）疲劳的嗜睡效果。使用混合方法设计和样品350 青少年和照顾者通过种族和社会经济地位平衡，我们将进行线性混合 建模以评估基线（时间不变）和夜间（随时间变化）键的关联 具有睡眠质量和数量，疲劳，嗜睡和在2周期间起作用的机制。 定性研究部分将重点介绍家庭/邻里因素和歧视形式 睡眠，青少年嗜睡与疲劳的经历以及解决问题的自我管理策略 睡眠和疲劳。该研究具有创新性：它只是研究了多种潜在机制 驱动青少年的睡眠差异，并使用新颖的技术来更好地衡量青少年睡眠的背景。 预期的结果将是重要的：识别睡眠分布的驱动因素对于改善睡眠至关重要，减少 疲劳和嗜睡，并改善青少年健康，功能和生活质量。而且，解开 由于它们的临床意义和治疗不同，因此需要白天嗜睡的疲劳。