Notice Number: NOT-HD-19-020

Key Dates
Release Date: September 4, 2019
First Available Due Date: October 5, 2019
Expiration Date: September 8, 2022

PA-19-056: Research Project Grant (Parent R01 Clinical Trial Not Allowed)
PA-18-480: NICHD Research Project Grant (R01 - Clinical Trial Required)
PA-18-482: NICHD Exploratory/Developmental Research Grant (R21 - Clinical Trial Optional)

Issued by
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Purpose

The development and maintenance of chronic pain involve long-term changes in multiple integrated peripheral, spinal, and brain neural pain networks that interact to contribute to the individual experience of pain. Many of these networks are immature at birth, then change in structure and function during the process of maturation. Pediatric chronic pain often emerges in adolescence, with co-morbid internalizing mental health and sleep problems.

Management of chronic pain has relied on opioids, with associated risks for adverse events and misuse. Sleep (and mental health) are modifiable risk factors for pain that can be improved with behavioral and nonopharmacologic interventions.

While there is substantial evidence that chronic pain can disrupt sleep, there is also growing evidence that sleep disturbances contribute to pain and that treatment of sleep disturbances can reduce pain. Emerging evidence indicates that sleep disturbances may be among several factors that predict the transition from acute to chronic pain. Furthermore, a meta-analysis of a few pilot studies of non-pharmacologic treatments of insomnia among chronic pain populations reported a small overall effect of reduced pain in the treatment groups relative to the control groups. However, more research is needed to validate these findings. Successful pain management (and prevention) necessitate a better understanding of how sleep disturbances (and their associated biological mechanisms) contribute to chronic pain, including its transition from acute pain. It is likely that chronic pain prevention and treatment can be more effective with explicit integration of sleep (and mental health).

Topics of Interest

NICHD supports sleep and pain research as it relates to pediatric, neonatal, and adolescent, and young adult populations, pregnant women, and persons with intellectual or physical disabilities. NICHD specific areas of interest include the following:

Child Development and Behavior Branch interest areas include sleep and pain among normally developing children and adolescents, including non-pharmacologic interventions (e.g., cognitive, behavioral, psychologic) interventions for sleep and pain management, prevention of transition from acute to chronic pain, and mitigation of the acute pain experience. Possible research questions of interest include:

• What are the neurobiological pathways underlying sleep-pain relationships in pediatric populations?
• In sleep deficiency, what mechanisms (e.g., inflammation, pain sensitization, circadian misalignment) are involved in central pain modulatory pathways, and how do changes in pain processing relate to increased clinical pain vulnerability? How does long-term sleep deficiency affect analgesic mediators? Are same mechanisms involved at different developmental stages?
• Which sleep parameters are most predictive of longitudinal pain outcomes? When are most sensitive periods for development and intervention?
• What is the relationship between central circadian timing and pain? How can interventions that shift circadian timing modify pain?
• How do positive and negative affect mediate relationships between sleep impairment and pain outcomes in pediatric populations? How do positive affect and resilience buffer the potential effects of poor sleep on pain and functioning?

National Center for Medical Rehabilitation Research: Sleep disturbances are described as components of physically disabling conditions neuromuscular, neurodegenerative, and cardiovascular disorders; CNS trauma, traumatic brain injury, spinal cord injury and stroke. During both acute and chronic rehabilitation periods, sleep disruption and pain are secondary conditions that affect the patient’s abilities to fully participate and adhere to rehabilitation regimens. Understanding the mechanisms of how sleep disturbances contribute to pain in the context of medical rehabilitation to include transition from acute to chronic pain is needed to address these concerns.

Application and Submission Information

This Notice applies to due dates on or after October 5, 2019 and subsequent receipt dates through September 8, 2022.

Submit applications for this initiative using one of the following FOAs or any reissues of these announcements through the expiration date of this Notice.

PA-19-056: Research Project Grant (Parent R01 Clinical Trial Not Allowed)

PA-18-480: NICHD Research Project Grant (R01 Clinical Trial Required)

PA-18-482: NICHD Exploratory/Developmental Research Grant (R21 - Clinical Trial Optional)

All instructions in the SF424 (R&R) Application Guide and referenced FOAs must be followed, with the following additions:

• For funding consideration, applicants must include "NOT-HD-19-020" (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B, or non-responsive to the terms of this NOSI will not be considered for this NOSI initiative.

Applicants planning to submit an application in response to this NOSI are strongly encouraged to contact the NICHD scientific/programmatic contact(s) listed on this NOSI in advance of the application due date.

Applications nonresponsive to terms of this NOSI will be not be considered for the NOSI initiative.

Inquiries