# Environmental Risk Factors for Pediatric Sleep Disordered Breathing

> **NIH NIH R01** · BOSTON CHILDREN'S HOSPITAL · 2020 · $862,710

## Abstract

ABSTRACT
Pediatric sleep disordered breathing (SDB) is associated with an increased risk for a wide range of
neurobehavioral and health effects that negatively impact child health, academic performance, and well-being,
as well as contribute to chronic health conditions across the lifespan. Minority children, vulnerable to life-long
health disparities, bear a disproportionate burden of SDB. Importantly, independent of race, children who
reside in disadvantaged neighborhoods are at a more than 3-fold increased risk for SDB, suggesting that
exposures in the home and neighborhood environment contribute to SDB, perhaps by stimulating
adenotonsillar hypertrophy and airway mucosal inflammation. An improved understanding of the
environmental factors that contribute to pediatric SDB is urgently needed to identify interventions for reducing
sleep health disparities. To address this need, we will leverage our extensive experience with community and
school-based environmental health research to recruit a sample of 300 children, ages 5 to 9 yrs from
predominantly low income households attending Boston Public Schools. Children and their families will
participate in a clinic and in-home exam, with collection of novel and low burdensome sleep and environmental
measurements. We will focus on the role of indoor irritants and allergens while also considering factors such as
indoor temperature, humidity, noise, outdoor pollution, respiratory illnesses, and neighborhood and family
characteristics. SDB and sleep duration will be assessed with overnight oximetry and 7 day sleep monitoring
using a validated device that quantifies movement and sound during sleep. Bedroom dust will be assayed for
allergens and endotoxin, and indoor environmental air quality monitors will measure NO2, PM2.5, temperature,
humidity and noise. Standardized questionnaires will characterize contextual factors, including social and
family characteristics, and child's behavior. We will rigorously characterize atopic status, lung function, and
second hand smoke exposure. Primary analyses will quantify the associations between environmental
exposures and SDB prevalence and severity and will evaluate the potential effect modification by factors such
as atopy. Longitudinal analyses will explore short and longer term variability and the impact of day to day
differences in the environment on SDB and sleep. Secondary analyses will further consider the role of
environmental factors on sleep duration and sleep continuity and the impact on SDB-related behavioral
outcomes. These unique data will identify modifiable factors that contribute to SDB, essential for developing
effective environmental control measures aimed at narrowing sleep health disparities.

## Key facts

- **NIH application ID:** 9969543
- **Project number:** 5R01HL137192-04
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** WANDA PHIPATANAKUL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $862,710
- **Award type:** 5
- **Project period:** 2017-09-08 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9969543

## Citation

> US National Institutes of Health, RePORTER application 9969543, Environmental Risk Factors for Pediatric Sleep Disordered Breathing (5R01HL137192-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9969543. Licensed CC0.

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