Determinants of insufficient sleep among blacks and effects on disparities in health outcomes

黑人睡眠不足的决定因素及其对健康结果差异的影响

• 批准号: 10614422
• 负责人: Girardin Jean-Louis
• 金额: $ 71.22万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10614422
• 关键词: Address; Adverse effects; Amyloid beta-Protein; Area; Attitude; Bayesian learning; Behavior Therapy; Behavioral Medicine; Behavioral Sciences; Belief; Black Populations; Brain Injuries; C-reactive protein; Cardiovascular Diseases; Circadian Rhythms; Circadian desynchrony; Communities; Data; Devices; Discrimination; Disease Marker; Disparity; Dyslipidemias; Emotional; Environment; Environmental Risk Factor; Exhibits; Exposure to; Foundations; Genetic; Glial Fibrillary Acidic Protein; Glucose; Glycosylated hemoglobin A; Goals; Health; Healthy People 2020; Home; Homocysteine; Hour; Household; Individual; Inflammation; Inflammatory; Insulin Resistance; Interleukin-10; Interleukin-6; Intervention; Laboratories; Light; Lipids; Longitudinal Studies; Low income; Metabolic syndrome; Modeling; Modification; Monitor; Morbidity - disease rate; Neighborhoods; Noise; Obesity; Outcome; Physiological; Psychosocial Factor; Public Health; Reporting; Research; Research Personnel; Risk; Role; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Sleeplessness; Social support; Socioeconomic Status; TNF gene; Temperature; Time; Translational Research; Underserved Population; United States National Institutes of Health; Vulnerable Populations; arterial stiffness; blood pressure elevation; brain health; built environment; cardiovascular disorder risk; density; disparity reduction; environmental stressor; ethnic disparity; ethnic minority; experience; health disparity; high risk; inflammatory marker; innovation; machine learning model; multidisciplinary; neurofilament; novel; novel marker; psychosocial; psychosocial stressors; racial disparity; racial minority; recruit; shift work; simulation; social; social capital; stem; success; tau Proteins; tool

Project Summary Insufficient sleep (IS), stemming from sleep apnea, shift work, insomnia, working over 40 hr./week, unfavorable sleep environments and/or volitional reduction of bedtime, is associated with increased risk of cardiovascular disease (CVD) markers (elevated blood pressure, insulin resistance, dyslipidemia and arterial stiffness), inflammatory markers (interleukin-6, tumor necrosis factor-α, and C-reactive protein) as well as with brain injury. Compelling evidence shows racial/ethnic disparities in insufficient sleep (IS), with blacks exhibiting a three-fold greater risk of IS relative to whites. Disparities might arise from physiologic and genetic factors, but recent evidence suggests environmental and psychosocial factors are also critical determinants. This study will utilize innovative dynamic modeling in a multi-level framework to delineate the psychosocial and environmental determinants (associative factors) of actigraphic IS and its putative associations with adverse health outcomes among blacks. Individual- and contextual-level data will be captured using novel home-based recordings and GIS data to model the environmental context where sleep occurs. The proposed study will leverage success of the NYU Sleep Disparity Workgroup led by Dr. Jean- Louis (PI), who has been conducting community-engaged sleep research for over 10 years. The workgroup comprises outstanding investigators with expertise in sleep and circadian rhythm, CVD, brain health, health disparities, translational behavioral medicine, and multi-level dynamic modeling. The study will benefit from experience of our standing Community Steering Committee, enabling recruitment of 560 blacks in various venues to participate in weeklong home studies to achieve proposed study aims. The multidisciplinary team will: 1) identify psychosocial (social support, discrimination, and attitudes/beliefs) and environmental (household [density, noise, light, and temperature], socioeconomic position, social capital, and neighborhood [built environment]) factors that are associated with IS; ascertain effects of IS on (a) markers of CVD (obesity, BP, lipid profile, and glucose/ HbA1C) and inflammation (IL-6, IL-10, and TNF-α) and on (b) markers of brain injury (tau, amyloid-β, neurofilament light, homocysteine, and glial fibrillary acidic protein; and develop profiles of blacks with IS-related adverse health outcomes using individual- and environmental-level data applying innovative multi-level dynamic modeling tools (Bayesia Belief Network and Agent-Based Simulation). This study will provide evidence to delineate factors underlying greater rates of IS among blacks and explain putative associations with markers of CVD, inflammation, and brain injury. These data will provide the foundation for longitudinal studies assessing causal effects of IS on these novel markers and interventions to mitigate adverse effects of IS on health outcomes.

项目摘要 睡眠不足（IS），来自睡眠呼吸暂停，班次工作，失眠，工作40小时/周 不利的睡眠环境和/或就寝时间减少，与增加的风险有关 心血管疾病（CVD）标记（浸润的血压，胰岛素抵抗，血脂异常和 动脉刚度），炎症标记（白介素6，肿瘤坏死因子-α和C反应蛋白）作为 以及脑损伤。令人信服的证据表明睡眠不足的种族/种族差异（IS），以及 黑人表现出比白人相对三倍的风险。生理可能引起的差异 和遗传因素，但最近的证据表明环境和社会心理因素也很关键 决定因素。这项研究将在多层框架中利用创新的动态建模来描述 Actraphic及其推定的心理社会和环境决定者（协会因素） 黑人之间与不利健康成果的联系。个人和上下文级别的数据将是 使用新型家庭记录和GIS数据捕获，以建模睡眠的环境环境 发生。拟议的研究将利用Jean-博士领导的NYU睡眠差异工作组的成功 路易斯（PI）从事社区参与的睡眠研究已有10多年了。工作组 包括在睡眠和昼夜节律，CVD，大脑健康，健康方面具有专业知识的杰出研究人员 差异，翻译的行为医学和多级动态建模。该研究将从 我们的常设社区指导委员会的经验，使各种黑人招募560个黑人 静脉参加为期一周的家庭研究，以实现拟议的研究目标。多学科团队 意志：1）确定社会心理（社会支持，歧视和参加/信仰）和环境 （家庭[密度，噪音，光和温度]，社会经济地位，社会资本和 邻里[建筑环境]）与IS相关的因素；确定IS对（a）标记的影响 CVD（肥胖，BP，脂质谱和葡萄糖/ HBA1C）和注射（IL-6，IL-10和TNF-α）以及ON （b）脑损伤的标记（tau，淀粉样蛋白β，神经丝光，同型半胱氨酸和神经胶质原纤维酸性 蛋白质;并使用个人和 环境级别的数据应用创新的多层次动态建模工具（贝叶斯信念网络 和基于代理的模拟）。这项研究将提供证据来描述率更高的因素 IS在黑人之中，并解释了与CVD，炎症和脑损伤标记的推定关联。 这些数据将为评估IS的因果影响的纵向研究提供基础 减轻不良影响的标记和干预措施对健康结果的不利影响。