Sleep Health in the Rural South and Its Relationships with Cardiometabolic Health Disparities

南方农村地区的睡眠健康及其与心脏代谢健康差异的关系

• 批准号: 10656596
• 负责人: Daniel J Gottlieb
• 金额: $ 134.14万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10656596
• 关键词: Accelerometer; Address; Adult; Affect; Age; Behavioral; Blood Pressure; Cardiometabolic Disease; Cardiovascular Diseases; Cardiovascular system; Communities; Complement; Complex; Data; Devices; Diet; Dimensions; Discrimination; Disease; Disparity population; Distress; Drops; Drowsiness; Enrollment; Environmental Exposure; Environmental Pollutants; Environmental Pollution; Environmental Risk Factor; Equilibrium; Etiology; Evaluation; Exposure to; Financial Hardship; General Population; Health; Health Personnel; Health Technology; Heterogeneity; High Prevalence; Home; Impairment; Individual; Industrialization; Insulin Resistance; Intervention; Link; Longitudinal Studies; Measures; Metabolic; Metabolic Diseases; Mississippi; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Nature; Obesity; Out-Migrations; Outcome; Oxygen; Oxygen saturation measurement; Population; Population Distributions; Predisposition; Prevalence; Prevention; Psychosocial Factor; Public Health; Questionnaires; Race; Recurrence; Research; Risk; Risk Factors; Rural; Rural Appalachia; Rural Community; Rural Population; Sampling; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Sleeplessness; Smoking; Social Impacts; Social isolation; Standardization; Stress; Time; United States; aged; base; built environment; burden of illness; cardiometabolic risk; cardiometabolism; cardiovascular risk factor; cohort; disorder risk; early life exposure; environmental stressor; epidemiology study; experience; fitbit; hazard; health care availability; health disparity; high risk; human old age (65+); improvement on sleep; mHealth; mortality; neighborhood disadvantage; physical inactivity; poor sleep; psychosocial; psychosocial stressors; resilience; resilience factor; rural area; rural dwellers; sex; sleep behavior; sleep health; sleep quality; social; social factors; stressor; substance use; systemic inflammatory response; urban area

PROJECT SUMMARY/ABSTRACT Rural communities in the southern U.S. suffer a disproportionate burden of morbidity and mortality from cardiometabolic disease, with traditional risk factors explaining only a modest proportion of the excess burden of disease. Growing evidence implicates poor sleep health as an important risk factor for cardiometabolic disease. While this is most well established for sleep apnea and insomnia, there is considerable evidence that multiple dimensions of sleep health, including sleep duration, efficiency, timing, and regularity, also affect cardiometabolic disease risk. Moreover, rural Southern communities are likely to experience high rates of impaired sleep health, reflecting high levels of psychosocial and environmental stressors, such as financial stress, social isolation, environmental pollution, and poor built environment in addition to high rates of smoking and obesity. However, there is currently a lack of systematically developed sleep data in rural populations. Recognizing the paucity of research on cardiometabolic risk in this high-risk rural population, the NHLBI recently initiated a new longitudinal epidemiology study in rural Appalachia and Mississippi Delta (the RURAL Study) to identify the complex individual, social and environmental factors contributing to this high burden of disease. The proposed RURAL Sleep Study will complement the RURAL Study by incorporating minimally burdensome measures of multiple dimensions of sleep health at the time of baseline cohort assessment in approximately 4000 adults age 25-64 years, utilizing mobile health technologies to (a) measure sleep apnea over 4 consecutive nights; (b) measure sleep duration, timing, regularity and fragmentation over multiple weeks; and (c) administer standardized questionnaires to assess insomnia, chronotype, sleep quality and sleep-related impairment. These data will allow us to leverage the planned extensive assessments of cardiometabolic risk factors, subclinical disease, and psychosocial and environmental stressors (and resilience factors) to address the following specific aims: Aim 1a. Quantify population distributions of sleep health measures in a rural cohort along dimensions of sleep apnea, insomnia, chronotype, and sleep duration, efficiency, timing, and regularity. Aim 1b. Identify psychosocial, behavioral, and environmental correlates of sleep health in rural communities. Aim 2. Assess the association of sleep health with cardiometabolic risk factors and subclinical cardiovascular disease independent of other established cardiovascular and metabolic risk factors. The results are expected to inform health care providers, public health officials, and the general public of the prevalence, risk factors, and consequences of impaired sleep health in these rural communities, providing a critical basis for prevention, recognition, and management of sleep disorders and improvement of sleep and cardiometabolic health.

项目概要/摘要 美国南部的农村社区承受着不成比例的发病率和死亡率负担 心脏代谢疾病，传统的危险因素只能解释一小部分超额负担 的疾病。越来越多的证据表明睡眠健康状况不佳是心脏代谢的重要危险因素 疾病。虽然这对于睡眠呼吸暂停和失眠来说是最确定的，但有大量证据表明 睡眠健康的多个维度，包括睡眠持续时间、效率、时间和规律性，也会影响 心脏代谢疾病风险。此外，南方农村社区的患病率可能很高 睡眠健康受损，反映了高水平的社会心理和环境压力，例如经济压力 除了高吸烟率之外，压力、社会孤立、环境污染、恶劣的建筑环境 和肥胖。然而，目前缺乏系统开发的农村人口睡眠数据。 认识到对这一高危农村人口心脏代谢风险的研究很少，NHLBI 最近在阿巴拉契亚和密西西比三角洲农村地区启动了一项新的纵向流行病学研究（RURAL 研究）以确定导致这种沉重负担的复杂个人、社会和环境因素 疾病。拟议的农村睡眠研究将通过最低限度地纳入农村研究来补充农村研究 在基线队列评估时对睡眠健康的多个维度进行繁琐的测量 大约 4000 名 25-64 岁的成年人利用移动医疗技术来 (a) 测量睡眠呼吸暂停 连续入住 4 晚以上； (b) 测量多次睡眠的持续时间、时间安排、规律性和分散性 几周； (c) 实施标准化问卷以评估失眠、睡眠时间型、睡眠质量和 睡眠相关的障碍。这些数据将使我们能够利用计划中的广泛评估 心脏代谢危险因素、亚临床疾病、心理社会和环境压力源（以及恢复力） 因素）来实现以下具体目标： 目标 1a。沿睡眠维度量化农村群体中睡眠健康指标的人口分布 呼吸暂停、失眠、睡眠时间类型以及睡眠持续时间、效率、时间和规律。 目标 1b。确定农村社区睡眠健康的社会心理、行为和环境相关性。 目标 2. 评估睡眠健康与心脏代谢危险因素和亚临床心血管疾病的关系 疾病独立于其他已确定的心血管和代谢危险因素。 预计结果将告知医疗保健提供者、公共卫生官员和公众 这些农村社区睡眠健康受损的患病率、风险因素和后果，提供了 预防、识别和管理睡眠障碍以及改善睡眠和睡眠质量的重要基础 心脏代谢健康。