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.

项目概要/摘要 意义。昼夜节律和睡眠中断以及睡眠呼吸暂停等睡眠障碍是高度 普遍存在并与一系列不良健康结果相关，包括心血管死亡率和 发病率。非裔美国人不成比例地受到昼夜节律紊乱/失调的影响， 睡眠中断和睡眠呼吸暂停；这可能是导致 CMB 健康不良的重要且独特的因素 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。然而，关于昼夜节律的研究有限。 AA 的自然环境，并且关于昼夜节律和昼夜节律的决定因素的知识存在重大差距 非裔美国人的睡眠中断。我们假设多层次的社会环境因素 昼夜节律失调的驱动因素（内部昼夜节律系统与行为或行为之间的不匹配） 环境循环），这会导致睡眠不规律，进而扰乱生理过程，例如 社会经济多样化的 AA 群体中的血压和新陈代谢。似乎有道理的是 假设的关联因 SES 和个人复原力而异；因此，我们将把复原力视为 可以减轻环境不利影响的保护因素。方法。善用资源 从佐治亚州亚特兰大的一群特征明确的非裔美国人中，我们建议使用重复的 旨在测试实时家庭和邻里层面因素（例如， 社会经济地位、夜间光线、噪音、空气污染）对心理社会因素的影响，严格评估昼夜节律 破坏/错位（包括家庭弱光褪黑激素开始测量内部内源性生物 节律）、睡眠规律（14 天体动记录、日记）和呼吸暂停（家庭多导睡眠图）以及相关的 这些措施对 400 个 AA 中 CMB 健康指标的影响。为了评估心脏代谢健康，我们将 测量 24 小时血压、动脉僵硬度以及炎症和代谢的生化标记物 功能障碍。我们将探讨个人层面的 SES 和复原力，作为假设的影响调节剂 协会。影响。 R01 的总体目标是阐明很大程度上无法解释的沉重负担 通过特别关注确定多层次的社会-代谢健康在非洲裔美国人中的不良心脏代谢健康 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 以及睡眠中断对 CMB 健康指标的影响。该项目将产生重大影响，因为它将确定 有助于 AA 昼夜节律和睡眠健康的显着社会环境因素（风险和保护）， 为根据文化量身定制的多层次干预措施提供信息，以减少睡眠和心血管差异。