Sleep deficiency and autonomic function in pediatric chronic abdominal pain

睡眠不足与小儿慢性腹痛的自主神经功能

基本信息

批准号：
10425413
负责人：
See Wan Tham
金额：
$ 17.72万
依托单位：
SEATTLE CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10425413
关键词：
Abdominal Pain Absenteeism Adolescent Adolescent Development Adult Affect Affective Age Anesthesiology Animals Anxiety Autonomic Dysfunction Autonomic nervous system Award Behavioral Biological Markers Caring Child Childhood Clinical Research Communities Data Development Dysautonomias Evaluation Functional disorder Gastroenterology Goals Health Healthcare Home Individual Instruction Interruption Intervention Knowledge Laboratories Link Longitudinal Studies Maintenance Mediating Medical Medicine Mental Depression Mentored Patient-Oriented Research Career Development Award Mentors Methodology Modeling Mood Disorders Neurobiology Outcome Pain Pain Clinics Pain Research Pathway interactions Pediatric Hospitals Physicians Physiological Polysomnography Population Process Proxy Psychological Factors Psychophysics Psychophysiology Public Health Quality of life Reporting Research Research Training Risk Role Schools Scientific Advances and Accomplishments Sleep Sleep Deprivation Sleep Disorders Sleep disturbances Sleeplessness Stimulus Stress Symptoms Syndrome Testing Time Training Treatment Factor United States Universities Washington actigraphy base career career development chronic abdominal pain chronic pain cohort comorbidity cost cost estimate disability effective therapy experience gut-brain axis health related quality of life heart rate variability longitudinal design modifiable risk novel novel strategies pain catastrophizing pain processing pain sensitivity pain-related disability patient oriented poor sleep potential biomarker professor programs psychologic psychological distress psychosocial recruit response sex skills sleep pattern sleep quality social stress therapy development

Abdominal Pain Absenteeism Adolescent Adolescent Development Adult Affect Affective Age Anesthesiology Animals Anxiety Autonomic Dysfunction Autonomic nervous system Award Behavioral Biological Markers Caring Child Childhood Clinical Research Communities Data Development Dysautonomias Evaluation Functional disorder Gastroenterology Goals Health Healthcare Home Individual Instruction Interruption Intervention Knowledge Laboratories Link Longitudinal Studies Maintenance Mediating Medical Medicine Mental Depression Mentored Patient-Oriented Research Career Development Award Mentors Methodology Modeling Mood Disorders Neurobiology Outcome Pain Pain Clinics Pain Research Pathway interactions Pediatric Hospitals Physicians Physiological Polysomnography Population Process Proxy Psychological Factors Psychophysics Psychophysiology Public Health Quality of life Reporting Research Research Training Risk Role Schools Scientific Advances and Accomplishments Sleep Sleep Deprivation Sleep Disorders Sleep disturbances Sleeplessness Stimulus Stress Symptoms Syndrome Testing Time Training Treatment Factor United States Universities Washington actigraphy base career career development chronic abdominal pain chronic pain cohort comorbidity cost cost estimate disability effective therapy experience gut-brain axis health related quality of life heart rate variability longitudinal design modifiable risk novel novel strategies pain catastrophizing pain processing pain sensitivity pain-related disability patient oriented poor sleep potential biomarker professor programs psychologic psychological distress psychosocial recruit response sex skills sleep pattern sleep quality social stress therapy development

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项目摘要

Project Summary/Abstract Childhood chronic abdominal pain is highly prevalent, and associated with significantly poorer physical and psychosocial functioning, and increased school absenteeism. Moreover, these children are at a greater risk of becoming adults with chronic abdominal pain, overlapping pain syndromes and psychosocial dysfunction. Chronic pain has become a public health crisis, with annual costs exceeding $600 billion. At present, the mechanisms underlying chronic abdominal pain are not well understood, limiting the development of interventions. There is now compelling evidence that sleep deficiency may be a precursor of pain development. Additionally, sleep deficiency is associated autonomic dysfunction and affective disorders that are commonly reported by individuals with chronic abdominal pain, highlighting shared central neurobiological processes. Understanding the role of sleep deficiency as a potential mechanism of chronic abdominal pain will expand avenues for treatment. The long term goal of this research program is to develop novel strategies to interrupt the trajectories of chronic abdominal pain. The objectives of this application are to elucidate the longitudinal impact of sleep deficiency on the course of abdominal pain in adolescents, and to delineate the roles of autonomic and psychological function in this relationship. The K23 candidate is an Assistant Professor in the Department of Anesthesiology and Pain Medicine at the University of Washington, and a pediatric pain physician and anesthesiologist at Seattle Children's Hospital. This proposal outlines a well-integrated research and training plan for mentored, patient oriented career development supported by an interdisciplinary team of mentors with expertise in adolescent development, psychophysiological research, longitudinal modeling, and clinical research applications. This award will provide the candidate with specialized instruction in the evaluation of sleep and cardiophysiological biomarkers in pediatric abdominal pain populations, and expertise in the conduct of longitudinal studies. The central aims are to compare sleep deficiency, pain processing, autonomic and psychological function in adolescents with chronic abdominal pain compared to healthy adolescents (Study 1); and to evaluate these longitudinal trajectories and inter-relationships for adolescents with chronic abdominal pain compared to healthy adolescents over 6 months (Study 2). Assessments will include subjective evaluation of pain, autonomic and psychological function, in addition to home-based actigraphy monitoring of sleep patterns that will be paired with laboratory assessment of psychophysical pain tasks and heart rate variability. Data generated from this research will directly inform a planned R01 proposal to develop tailored interventions targeting sleep deficiency and autonomic function as modifiable risk factors for treatment. Completion of the proposed training will prepare the candidate for a successful independent research career in pediatric chronic abdominal pain medicine.

项目摘要/摘要儿童慢性腹部疼痛非常普遍，并且与身体差明显较差和社会心理功能，增加了学校旷工。而且，这些孩子面临着更大的风险成为慢性腹痛，疼痛综合征和社会心理功能障碍的成年人。慢性疼痛已成为公共卫生危机，年成本超过6000亿美元。目前，慢性腹痛的机制尚不清楚，限制了干预措施。现在有令人信服的证据表明睡眠不足可能是疼痛发育的前体。此外，睡眠不足是相关的自主功能障碍和通常是情感障碍由患有慢性腹痛的个体报道，突出了共有的中枢神经生物学过程。将睡眠不足作为慢性腹痛的潜在机制的作用将扩大治疗途径。该研究计划的长期目标是制定新颖的策略以中断慢性腹痛的轨迹。该应用程序的目标是阐明纵向睡眠不足对青少年腹痛的影响，并描述这种关系中的自主和心理功能。 K23候选人是华盛顿大学麻醉与止痛药和小儿疼痛西雅图儿童医院的医师和麻醉师。该提议概述了一项整合的研究以及针对指导的，以患者为导向的职业发展的培训计划，由一个跨学科团队支持具有青少年发展，心理生理研究，纵向建模和临床研究应用。该奖项将为候选人提供专业指导评估儿科腹痛种群中的睡眠和心脏生理生物标志物和专业知识在纵向研究的进行中。中心目的是比较睡眠不足，疼痛处理，与健康相比青少年（研究1）；并评估青少年的这些纵向轨迹和相互关系与健康的青少年相比，慢性腹痛在6个月内（研究2）。评估将除了家庭之外，还包括疼痛，自主和心理功能的主观评估对睡眠模式的积极监测将与心理疼痛的实验室评估配对任务和心率变异性。这项研究产生的数据将直接告知计划的R01提案制定针对睡眠不足和自主功能的量身定制干预措施，作为可修改的风险因素治疗。拟议培训的完成将为候选人做好准备的成功独立小儿慢性腹痛医学的研究职业。