Multilevel Determinants of Circadian Factors and Sleep Disruption: Implications for Cardiometabolic Health Among African-Americans

昼夜节律因素和睡眠中断的多层次决定因素：对非裔美国人心脏代谢健康的影响

• 批准号: 10451280
• 负责人: Dayna Johnson
• 金额: $ 74.34万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10451280
• 关键词: Adult; Adverse effects; Affect; African American population; Air; Air Pollution; Apnea; Behavioral; Biochemical Markers; Biological Rhythm; Blood Glucose; Blood Pressure; Buffers; Cardiovascular Diseases; Cardiovascular system; Characteristics; Circadian Dysregulation; Circadian Rhythms; Circadian desynchrony; Clinic; Clinical; Controlled Environment; Data; Diabetes Mellitus; Disadvantaged; Electronics; Environment; Environmental Exposure; Environmental Risk Factor; Goals; Health; Home; Hour; Household; Housing; Hypertension; Individual; Inflammation; Intervention; Knowledge; Laboratory Study; Light; Link; Measurement; Measures; Melatonin; Metabolic dysfunction; Metabolism; Morbidity - disease rate; Neighborhoods; Noise; Obesity; Outcome; Physiological Processes; Pollution; Polysomnography; Population; Proxy; Psychosocial Factor; Psychosocial Stress; Research; Resources; Risk; Safety; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Social Environment; Socioeconomic Status; System; Technology; Testing; Time; Variant; actigraphy; arterial stiffness; base; cardiometabolism; cardiovascular health; circadian; cohort; coping; design; diaries; effective intervention; environmental adaptation; inflammatory marker; mortality; noise pollution; prevent; protective factors; resilience; sleep health; socioeconomics; socioenvironmental factor; urban area; ventilation

PROJECT SUMMARY/ABSTRACT Significance. Circadian and sleep disruption, and sleep disorders such as sleep apnea, are highly prevalent and associated with a host of adverse health outcomes including cardiovascular mortality and morbidity. African-Americans are disproportionately affected by disrupted/misaligned circadian rhythms, disrupted sleep and sleep apnea; which may be important, unique contributors to adverse CMB health in African-Americans. Reducing the burden of adverse cardiometabolic health in African-Americans may involve targeting both circadian rhythms and sleep. However, limited research exists on circadian rhythms in the natural environment of AAs, and there are major gaps in knowledge about the determinants of circadian and sleep disruption within African-Americans. We hypothesize that multilevel socio-environmental factors are drivers of circadian misalignment (a mismatch between the internal circadian system and behavioral or environmental cycles), which contribute to irregular sleep, and in turn disrupts physiologic processes such as blood pressure and metabolism in a socioeconomically diverse cohort of AAs. It is plausible that the hypothesized association differs by SES and individual resilience; thus, we will consider resilience as a protective factor that may mitigate the adverse effects of the environment. Approach. Leveraging resources from a well characterized cohort of African-Americans in Atlanta Georgia, we propose to use a repeated measures design to test the cumulative effects of real-time household- and neighborhood-level factors (e.g., socioeconomic status, light at night, noise, air pollution) on psychosocial factors, rigorously assessed circadian disruption/misalignment (including home dim light melatonin onset to measure internal endogenous biologic rhythms), sleep regularity (14-day actigraphy, diary) and apnea (in-home polysomnography) and relatedly, the impact of these measures on markers of CMB health in 400 AAs. To assess cardiometabolic health we will measure 24-hour blood pressure, arterial stiffness, and biochemical markers of inflammation and metabolic dysfunction. We will explore individual-level SES and resilience as effect modifiers of the hypothesized associations. Impact. The overarching aim of this R01 is to elucidate the largely unexplained high burden of adverse cardiometabolic health in African-Americans by specifically focusing on identifying the multilevel socio- environmental determinants of circadian and sleep disruption, and determining the relative impact of circadian and sleep disruption on markers of CMB health. This project will have a high impact, because it will identify salient socio-environmental factors (risk and protective) that contribute to circadian and sleep health in AAs, to inform culturally tailored multilevel interventions to reduce sleep and cardiovascular disparities.

项目摘要/摘要 意义。昼夜节律和睡眠中断，睡眠障碍（例如睡眠呼吸暂停）高度高度 普遍，与许多不良健康结果有关，包括心血管死亡率和 发病率。非裔美国人受到破坏/未对准的昼夜节律的影响不成比例的 破坏睡眠和睡眠呼吸暂停；这可能是不利CMB健康的重要，独特的贡献者 非裔美国人。减轻非裔美国人不良心脏代谢健康的负担可能涉及 针对昼夜节律和睡眠。但是，关于昼夜节律的研究有限 AAS的自然环境，关于昼夜节律决定因素的知识存在很大的差距 非裔美国人内部的睡眠中断。我们假设多级社会环境因素是 昼夜节律未对准的驱动因素（内部昼夜行为与行为或行为之间的不匹配或 环境周期），有助于不规则睡眠，进而破坏了生理过程 在社会经济上多样的AAS中，血压和代谢。合理的是 假设的关联因SES和个人的弹性而有所不同；因此，我们将弹性视为 保护因素可能会减轻环境的不利影响。方法。利用资源 来自佐治亚州亚特兰大的非裔美国人队列的特征，我们建议使用重复 测量设计实时家庭和邻里水平因素的累积影响的措施（例如， 社会经济状况，夜晚的光，噪音，空气污染）对心理因素，严格评估的昼夜节律 破坏/未对准（包括家用昏暗的光褪黑激素发作以测量内源性生物学 节奏），睡眠规律性（14天的动作术，日记）和呼吸暂停（在家多个术语）以及相关的 这些措施对400 AA中CMB健康标记的影响。为了评估心脏代谢健康，我们将 测量24小时的血压，动脉僵硬以及炎症和代谢的生化标志物 功能障碍。我们将探索个人级别的SE和弹性，作为假设的效果修饰符 协会。影响。该R01的总体目的是阐明很大程度上无法解释的高负担 非洲裔美国人的不良心脏代谢健康，专门专注于确定多层次社会 - 昼夜节律和睡眠中断的环境决定因素，并确定昼夜节律的相对影响 和CMB健康标记的睡眠中断。该项目将产生很大的影响，因为它将确定 有助于AAS的昼夜节律和睡眠健康的显着社会环境因素（风险和保护性） 告知文化量身定制的多层次干预措施，以减少睡眠和心血管差异。