R01HD104601

Sleep Disparities' Role in Adolescent Fatigue and Functioning: A Mixed-Methods Study - Abstract

Fatigue is a frequently reported complaint of adolescents and is linked to a wide range of adverse health, behavioral, and functional outcomes. Disparities in fatigue prevalence exist, with greater frequency seen in minority, economically disadvantaged populations. Disparities in sleep quantity and quality also fall along ethnic and economic lines, with poorer sleep observed among the economically disadvantaged and persons of color. Because of fatigue's strong link with inadequate sleep, our understanding of fatigue will benefit from greater awareness of its relationship with sleep disparities, especially among early adolescents, when notable racial differences in sleep duration and timing emerge.

Numerous social-environmental factors in individual, household, and neighborhood levels may serve as risk and resilience factors shaping disparities in sleep and fatigue. Yet, the relative contributions of these factors are yet unclear. Moreover, the association between inadequate sleep and fatigue is obscured by another common teen complaint: daytime sleepiness. The relationship between fatigue and sleepiness, and their differential effects on adolescent health and functioning are yet unclear.

Our study purpose is to identify key mechanisms underlying racial and economic disparities in sleep and their association with fatigue, daytime sleepiness, and functioning in early adolescents. We posit that differences in household organization, socioeconomic disadvantage, and experiences of discrimination are key drivers of sleep disparity between African American and white adolescents. Guided by a community advisory board, and using a novel smartphone/sensor technology developed in our pilot research on adolescent sleep, we propose a home-based study among African American and white adolescents in Cleveland, OH to (a) identify factors responsible for adolescent sleep disparities; (b) determine the effects of sleep disparities on fatigue, daytime sleepiness, and functioning; and (c) disentangle effects of sleepiness from fatigue.

Using a mixed-methods design and a sample of 350 adolescents and caregivers balanced by race and socio-economic status, we will conduct linear mixed modeling to assess associations between baseline (time-invariant) and nightly (time-varying) measures of key mechanisms with that of sleep quality and quantity, fatigue, sleepiness, and functioning over a 2-week period. A qualitative study component will focus on how household/neighborhood factors and discrimination shape sleep, the teen experience of sleepiness vs. fatigue, and self-management strategies to address problematic sleep and fatigue.

The study is innovative: it simultaneously investigates multiple potential mechanisms driving adolescent sleep disparities and uses novel technology to better measure the context of teen sleep. Expected results will be significant: identifying drivers of sleep disparities is vital to improve sleep, reduce fatigue and sleepiness, and improve adolescent health, functioning, and quality of life. Moreover, disentangling fatigue from daytime sleepiness is needed because their clinical implications and treatment differ.

Case Western Reserve University

TO CONDUCT AND SUPPORT LABORATORY RESEARCH, CLINICAL TRIALS, AND STUDIES WITH PEOPLE THAT EXPLORE HEALTH PROCESSES. NICHD RESEARCHERS EXAMINE GROWTH AND DEVELOPMENT, BIOLOGIC AND REPRODUCTIVE FUNCTIONS, BEHAVIOR PATTERNS, AND POPULATION DYNAMICS TO PROTECT AND MAINTAIN THE HEALTH OF ALL PEOPLE. TO EXAMINE THE IMPACT OF DISABILITIES, DISEASES, AND DEFECTS ON THE LIVES OF INDIVIDUALS. WITH THIS INFORMATION, THE NICHD HOPES TO RESTORE, INCREASE, AND MAXIMIZE THE CAPABILITIES OF PEOPLE AFFECTED BY DISEASE AND INJURY. TO SPONSOR TRAINING PROGRAMS FOR SCIENTISTS, DOCTORS, AND RESEARCHERS TO ENSURE THAT NICHD RESEARCH CAN CONTINUE. BY TRAINING THESE PROFESSIONALS IN THE LATEST RESEARCH METHODS AND TECHNOLOGIES, THE NICHD WILL BE ABLE TO CONDUCT ITS RESEARCH AND MAKE HEALTH RESEARCH PROGRESS UNTIL ALL CHILDREN, ADULTS, FAMILIES, AND POPULATIONS ENJOY GOOD HEALTH. THE MISSION OF THE NICHD IS TO ENSURE THAT EVERY PERSON IS BORN HEALTHY AND WANTED, THAT WOMEN SUFFER NO HARMFUL EFFECTS FROM REPRODUCTIVE PROCESSES, AND THAT ALL CHILDREN HAVE THE CHANCE TO ACHIEVE THEIR FULL POTENTIAL FOR HEALTHY AND PRODUCTIVE LIVES, FREE FROM DISEASE OR DISABILITY, AND TO ENSURE THE HEALTH, PRODUCTIVITY, INDEPENDENCE, AND WELL-BEING OF ALL PEOPLE THROUGH OPTIMAL REHABILITATION.

93.865 - Child Health and Human Development Extramural Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

Cleveland, Ohio 44106 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the End Date has been extended from 03/31/26 to 01/31/27 and the total obligations have increased 339% from $727,957 to $3,196,466.