Stress, Sleep and Cardiovascular Risk
| Status: | Recruiting |
|---|---|
| Conditions: | Insomnia Sleep Studies, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 35 |
| Updated: | 4/17/2018 |
| Start Date: | October 1, 2017 |
| End Date: | October 31, 2021 |
| Contact: | Travan Hurst, BA |
| Email: | TLHurst@Howard.edu |
| Phone: | 202-865-7267 |
We are evaluating a model where trauma exposure and threatening environments elicit nocturnal
vigilance and sleep-related fears that compromise the healthy reduction of autonomic arousal
during sleep which in turn stimulates secretion of atherogenic humoral factors, arterial
stiffening, and cardiovascular disease risk. We will examine the roles of pre-sleep cognition
using a questionnaire and real time assessment, and modifiable strategies for coping with
sleep disruptive cognitions. We will then evaluate the impact of providing personalized
feedback and recommendations based on study observations on how participants cope with
potentially sleep disruptive cognitions and sleep efficiency in a randomized trial.
vigilance and sleep-related fears that compromise the healthy reduction of autonomic arousal
during sleep which in turn stimulates secretion of atherogenic humoral factors, arterial
stiffening, and cardiovascular disease risk. We will examine the roles of pre-sleep cognition
using a questionnaire and real time assessment, and modifiable strategies for coping with
sleep disruptive cognitions. We will then evaluate the impact of providing personalized
feedback and recommendations based on study observations on how participants cope with
potentially sleep disruptive cognitions and sleep efficiency in a randomized trial.
The study has 3 specific aims.
Aim 1. To confirm the effects of neighborhood and posttraumatic stress, and nocturnal
vigilance on nocturnal autonomic balance determined by complementary biomarkers.
Hypothesis 1a - Neighborhood disorder and posttraumatic stress symptom severity will be
inversely correlated with indicators of autonomic balance derived from analyses of heart rate
variability and cardiac impedence, and nocturnal/evening urinary noradrenergic excretion
ratios.
Hypothesis 1b - These relationships will be partially or fully accounted for by nocturnal
vigilance and the frequency and intensity of pre-sleep disruptive cognitions assessed in real
time, and strategies for coping with sleep disruptive thoughts.
Aim 2. To determine relationships of nocturnal autonomic activity to biomarkers of
inflammation and endothelial dysfunction.
Hypothesis 2 - Indicators of nocturnal autonomic balance will correlate with morning levels
of pro-inflammatory cytokines and adhesion molecules; and pulse wave velocity.
Aim 3. To determine if sleep is improved 6 months after receiving personalized
recommendations for adaptively modifying sleep-related behaviors, and if improved sleep and
reduced pre-sleep cognitive arousal are associated with more favorable nocturnal autonomic
balance and endothelial function.
Hypothesis 3a - Reduced frequency and intensity of sleep disruptive cognitions and improved
sleep efficiency will be more likely in the group that received personalized feedback and
recommendations for sleep.
Hypothesis 3b - Reduction of disruptive pre-sleep cognitions, and increased sleep efficiency
will be associated with improved autonomic status at night and a more favorable profile of
cardiovascular risk biomarkers.
Aim 1. To confirm the effects of neighborhood and posttraumatic stress, and nocturnal
vigilance on nocturnal autonomic balance determined by complementary biomarkers.
Hypothesis 1a - Neighborhood disorder and posttraumatic stress symptom severity will be
inversely correlated with indicators of autonomic balance derived from analyses of heart rate
variability and cardiac impedence, and nocturnal/evening urinary noradrenergic excretion
ratios.
Hypothesis 1b - These relationships will be partially or fully accounted for by nocturnal
vigilance and the frequency and intensity of pre-sleep disruptive cognitions assessed in real
time, and strategies for coping with sleep disruptive thoughts.
Aim 2. To determine relationships of nocturnal autonomic activity to biomarkers of
inflammation and endothelial dysfunction.
Hypothesis 2 - Indicators of nocturnal autonomic balance will correlate with morning levels
of pro-inflammatory cytokines and adhesion molecules; and pulse wave velocity.
Aim 3. To determine if sleep is improved 6 months after receiving personalized
recommendations for adaptively modifying sleep-related behaviors, and if improved sleep and
reduced pre-sleep cognitive arousal are associated with more favorable nocturnal autonomic
balance and endothelial function.
Hypothesis 3a - Reduced frequency and intensity of sleep disruptive cognitions and improved
sleep efficiency will be more likely in the group that received personalized feedback and
recommendations for sleep.
Hypothesis 3b - Reduction of disruptive pre-sleep cognitions, and increased sleep efficiency
will be associated with improved autonomic status at night and a more favorable profile of
cardiovascular risk biomarkers.
Inclusion Criteria:1. Healthy adults age 18 - 35, self-identified as Black or African
American, born in the United States.
Exclusion Criteria:
- current medical or psychiatric condition that affects sleep or requires daily - use of
medication other than PTSD, phobic disorders, or past history of major depression
- severe alcohol or drug use disorders
- overnight shift worker or an extreme chronotype
- sleep disorder other than insomnia or nightmares
- morbid obesity (body mass index > 40)
We found this trial at
1
site
Washington, District of Columbia 20060
Principal Investigator: Thomas A Mellman, M.D.
Phone: 202-865-7276
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