Sleep Management And Recovery after Traumatic Brain Injury in Kids (SMART-Kids): Evidence for targeting sleep to improve outcomes

儿童脑外伤后的睡眠管理和恢复（SMART-Kids）：以睡眠为目标以改善结果的证据

• 批准号: 10263224
• 负责人: Cydni Nicole Williams
• 金额: $ 16.63万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10263224
• 关键词: Academic achievement; Acute; Acute Brain Injuries; Address; Affect; Anti-Inflammatory Agents; Attention; Behavior; Behavior Therapy; Brain; Characteristics; Child; Child Care; Childhood; Chronic; Clinic; Clinical; Clinical Oncology Supplement (K12); Clinical Research; Clinical Trials; Cognitive; Cognitive deficits; Critical Care; Critical Illness; Critically ill children; Data; Data Analyses; Development; Early Intervention; Effectiveness; Equipment and supply inventories; Executive Dysfunction; Functional disorder; Funding; Goals; Health Sciences; Hospitalization; Impaired cognition; Impairment; Inflammatory; Injury; Intervention; Lead; Linear Regressions; Longitudinal cohort study; Maintenance; Measures; Melatonin; Memory; Mentors; Mentorship; Methodology; Modeling; Monitor; Morbidity - disease rate; Neurons; Oregon; Outcome; Patients; Pediatric Intensive Care Units; Performance; Phenotype; Physicians; Prevention; Problem behavior; Productivity; Property; Prospective cohort study; Publications; Quality of life; Questionnaires; Randomized Controlled Trials; Recording of previous events; Recovery; Research; Research Proposals; Risk Factors; SECTM1 gene; Sleep; Sleep Disorders; Sleep disturbances; Survivors; Targeted Research; Testing; Training; Traumatic Brain Injury; Traumatic Brain Injury recovery; United States National Institutes of Health; Universities; Work; Wrist; acceptability and feasibility; actigraphy; aged; career development; clinical care; cognitive testing; cohort; cost; effective intervention; effective therapy; evidence base; executive function; follow-up; healing; high risk; improved; improved outcome; longitudinal analysis; modifiable risk; multidisciplinary; multimodality; patient oriented; pediatric traumatic brain injury; poor sleep; prevent; prospective; psychosocial; randomized placebo controlled trial; skills; standard care

Project Summary Sleep is critical for brain maturation and development in childhood, and for neuronal healing after injury. Traumatic brain injury (TBI) is a common pediatric critical illness affecting more than 50,000 children annually, half of whom suffer acute and chronic sleep wake disturbances (SWD) leading to impaired quality of life. These children also suffer substantial cognitive impairments for many years after injury, particularly in domains of executive function, leading to reduced academic performance and psychosocial dysfunction. Whether sleep disturbances significantly compound these cognitive deficits after TBI remains unknown. Additionally, effective therapies shown to prevent or improve SWD and executive dysfunction among these vulnerable children are lacking. The central hypothesis of this proposal is that SWD are an independent and modifiable risk factor for executive function impairment in children surviving TBI. The objectives of the proposed research are to: 1) Determine the longitudinal association between SWD and executive function after pediatric TBI in a prospective cohort study using both questionnaires and objective measures, 2) Evaluate feasibility and effectiveness of an early melatonin and sleep management intervention started during hospitalization in a single-center randomized controlled trial. Dr. Cydni Williams is a Pediatric Critical Care physician at Oregon Health & Science University where she cares for critically ill children acutely in the pediatric intensive care unit and longitudinally in a critical care follow-up clinic. Her work has identified SWD as an important morbidity affecting more than half of critical care survivors, particularly in the large number of TBI survivors she follows. Her long-term goal is to improve longitudinal outcomes and quality of life through rigorous studies identifying effective interventions to improve sleep disturbances after pediatric critical care, by first evaluating the high risk cohort of TBI survivors. This career development proposal will provide Dr. Williams with experiential and mentored training conducting sleep research, clinical trial methodology, and longitudinal data analyses. This proposal is significant because it addresses the common and debilitating morbidity of SWD that affect thousands of pediatric TBI survivors annually, advances clinical care and research through testing an early sleep management intervention, and aligns with the National Institutes of Health Sleep Disorders Research Plan. This research and multi- disciplinary mentored training will provide Dr. Williams with data and research expertise needed to pursue independent research funding to evaluate SWD in pediatric TBI and other critical illness survivors.

项目摘要 睡眠对于童年的脑成熟和发育至关重要，受伤后的神经元愈合至关重要。 创伤性脑损伤（TBI）是一种常见的小儿危害疾病，每年影响50,000多名儿童 其中一半遭受了急性和慢性睡眠唤醒障碍（SWD），导致生活质量受损。这些 受伤后多年，儿童也遭受了严重的认知障碍，尤其是在 执行功能，导致学习成绩降低和社会心理功能障碍。是否睡觉 在TBI之后，这些认知缺陷显着加剧了干扰仍然未知。另外，有效 这些易受伤害儿童的疗法可预防或改善SWD和执行功能障碍 缺乏。该提议的核心假设是SWD是独立且可修改的风险因素 持有TBI的儿童的执行功能障碍。拟议研究的目标是：1） 确定小儿TBI后SWD与执行功能之间的纵向关联 使用问卷和客观措施的前瞻性队列研究，2）评估可行性和 早期褪黑激素和睡眠管理干预的有效性在住院期间开始 单中心随机对照试验。 Cydni Williams博士是俄勒冈健康与科学大学的儿科重症监护医师 在小儿重症监护病房急性疾病的孩子，在重症监护病房中急性照顾 后续诊所。她的工作将SWD确定为影响一半以上重症监护的重要发病率 幸存者，特别是在她跟随的大量TBI幸存者中。她的长期目标是改善 通过严格的研究确定有效的干预措施以改善的纵向结果和生活质量 小儿重症监护后的睡眠障碍，首先评估TBI幸存者的高风险队列。这 职业发展建议将为威廉姆斯博士提供体验和指导的培训，以进行睡眠 研究，临床试验方法和纵向数据分析。该提议很重要，因为它 解决影响数千个小儿TBI幸存者的常见和令人衰弱的发病率 每年，通过测试早期睡眠管理干预措施来进步临床护理和研究 与美国国立卫生研究院睡眠障碍研究计划保持一致。这项研究和多数 纪律指导培训将为威廉姆斯博士提供追求所需的数据和研究专业知识 独立的研究资金，以评估小儿TBI和其他批评疾病幸存者中的SWD。