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

• 批准号: 10652330
• 负责人: See Wan Tham
• 金额: $ 17.09万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10652330
• 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; 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

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.

项目概要/摘要 儿童期慢性腹痛非常普遍，并且与身体状况和身体状况明显较差有关。 心理社会功能，以及学校缺勤率增加。此外，这些儿童面临更大的风险 成年后患有慢性腹痛、重叠疼痛综合征和心理社会功能障碍。 慢性疼痛已成为一场公共卫生危机，每年造成的损失超过 6000 亿美元。目前， 慢性腹痛的机制尚不清楚，限制了慢性腹痛的发展 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生的先兆。 此外，睡眠不足与植物神经功能障碍和情感障碍有关，这些疾病通常是 由患有慢性腹痛的个体报告，强调了共同的中枢神经生物学过程。 将进一步了解睡眠不足作为慢性腹痛潜在机制的作用 治疗途径。该研究计划的长期目标是开发新颖的策略来中断 慢性腹痛的轨迹。本申请的目的是阐明纵向 睡眠不足对青少年腹痛病程的影响，并描述睡眠不足的作用 自主神经和心理功能有这种关系。 K23候选人是助理教授 华盛顿大学麻醉学和疼痛医学系以及儿科疼痛 西雅图儿童医院的医生和麻醉师。该提案概述了一项综合性研究 以及由跨学科团队支持的指导式、以患者为导向的职业发展培训计划 具有青少年发展、心理生理学研究、纵向建模专业知识的导师 临床研究应用。该奖项将为候选人提供以下方面的专门指导： 小儿腹痛人群睡眠和心脏生理生物标志物的评估以及专业知识 在进行纵向研究时。中心目标是比较睡眠不足、疼痛处理、 与健康青少年相比，患有慢性腹痛的青少年的自主神经和心理功能 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 6 个月以上的健康青少年相比，患有慢性腹痛的青少年（研究 2）。评估将 除了基于家庭的评估外，还包括对疼痛、自主神经和心理功能的主观评估 睡眠模式的体动记录仪监测将与心理物理疼痛的实验室评估相结合 任务和心率变异性。这项研究产生的数据将直接为计划中的 R01 提案提供信息 制定针对睡眠不足和自主功能的定制干预措施，将其作为可改变的危险因素 治疗。完成拟议的培训将使候选人为成功的独立做好准备 主要从事儿科慢性腹痛医学研究。