The association between adverse childhood experiences and insomnia symptoms from adolescence to adulthood: Evidence from the Add Health study

The effects of sexual orientation and adverse childhood experiences on short sleep duration: Evidence from the behavioral risk factor surveillance system (BRFSS)

BACKGROUND

Adverse childhood experiences (ACEs) are associated with an increased risk of short sleep duration in adulthood. This study aims to explore the relationship between sexual orientation, ACEs and short sleep duration.

METHODS

61,323 adults from the Behavioral Risk Factor Surveillance System (BRFSS) were included in this study. We measured sexual orientation, ACEs and short sleep duration with participants' self-report. Multivariate logistic regression analysing the effects of sexual orientation, ACEs and their interactions on short sleep duration.

RESULTS

More sexual minoritized individuals reported short sleep duration compared to heterosexual individuals (32.10 % for heterosexuals; 33.70 % for sexual minoritized individuals). More sexual minoritized individuals reported being exposed to >1 ACE (heterosexual = 62.8 %; sexual minoritized individuals = 82.2 %. P < 0.001) than heterosexuals, especially sexual minorities are about three times more likely than heterosexual to be sexually abused (heterosexual = 11.1 %; sexual minoritized individuals = 31.2 %, P < 0.001). More bisexual women reported sexual abuse than bisexual men (38.2 % for bisexual women; 22.6 % for bisexal men). Positive association between ACEs status and short sleep duration (OR:2.23, 95%CI: 1.36,3.65) was identified among sexual minoritized individuals. Those sexual minorities individuals who experienced sexual abuse in childhood, emotional abuse, and mental illness in the household had 1.72, 1.38, and 1.39 times the risk of having a short sleep duration in adulthood as compared to heterosexual household, respectively. Moreover, there was a significant interaction between sexual abuse and sexual orientation.

LIMITATIONS

The cross-sectional design limited the ability to make causal inference.

CONCLUSION

This study shows that sexual abuse experiences suffered by sexual minority adults during childhood may lead to a higher risk of subsequent short sleep duration as well. Thus, the risk of short sleep duration in sexual minorities is reduced by reducing the occurrence of ACEs.

The impact of adverse childhood experiences on older adults' health measured via comprehensive geriatric assessment

BACKGROUND

Adverse childhood experiences (ACEs) are potentially traumatic events that occur up to the age of 18 years. Such trauma often results in chronic psychological stress that is associated with negative health outcomes across the lifespan. The aim of this study is to investigate associations between ACEs and health outcomes in older adults.

METHODS

The present study is a cross-sectional design. Socio-demographic information on patients' age, gender, marital status, living status, and education level were collected. Furthermore, a comprehensive geriatric assessment and ACE scale were conducted. The ACE scale consisted of 10 questions that were categorised as psychological, physical, and sexual abuse, as well as neglect. The relationship between detailed comprehensive geriatric assessment parameters and ACE were analyzed.

RESULTS

There were 276 (mean age 77.9 ± 7.3 years, and 74.3% female) patients included in the study. The prevalence of ACEs was 43.1%, with psychological ACE being the most common. Female gender, number of medications, the presence of insomnia and dysphagia were higher in older patients who experienced at least one ACE than those without ACE (P < 0.05). In multivariate analyses, only the relationship between insomnia and ACE persisted (odds ratio 1.83, 95% CI 1.12-3.01; P < 0.05).

CONCLUSIONS

ACEs were detected in approximately one in every two older adults. Those with ACEs were 1.8 times more likely to experience insomnia. Therefore, when evaluating an older patient with insomnia, ACEs should be evaluated and insomnia should also be questioned in older patients who have experienced ACE.

Parental divorce's long shadow: Elevated stroke risk among older Americans

Although studies have investigated the association between adverse childhood experiences and chronic health outcomes including stroke, few studies have investigated the association between parental divorce and stroke among adults with no history of childhood abuse. The objectives of this study were to investigate the association between parental divorce in childhood and stroke in older adulthood among those who did not experience child abuse and to examine whether this association differs between men and women. This study utilized population-based data from the 2022 Behavioral Risk Factor Surveillance System. An analytic sample of 13,205 adults aged 65 and above (56.6% female) who have never experienced childhood physical nor sexual abuse were analyzed using binary logistic regression. The outcome variable investigated was self-report of a physician-diagnosis of stroke, and the main exposure of interest was parental divorce. In this sample of older adults, 7.3% reported having stroke, while 13.9% reported that their parents had divorced before the respondent was 18 years old. Controlling for the effects of other factors, respondents who experienced parental divorce had 1.61 times higher odds of having a stroke when compared to their counterparts who did not experience parental divorce (AOR = 1.61, 95% CI = 1.15-2.24). The association between parental divorce and stroke was not dependent on sex; however, compared to females, males had 1.47 times higher odds of having a stroke (AOR = 1.47, 95% CI = 1.11-1.93). The findings of this study suggest that individuals in this cohort whose parents divorced as children were at greater risk for stroke later in life. Potentially moderating variables were hypothesized, including childhood poverty, sleep hygiene, and hypertension.

Recent Stressful Life Events and Perceived Stress as Serial Mediators of the Association between Adverse Childhood Events and Insomnia

Insomnia is common in college students and linked to poorer mental and physical health. There is growing evidence that adverse childhood experiences (ACEs) may contribute to insomnia in adulthood. However, beyond the need for additional replication of these findings, there is a need to identify underlying mechanisms that plausibly connect the two experiences. Based on a serial mediation model, the current study examined the role of two theoretically informed mediators: recent stressful life events and perceived stress. A cross-sectional survey of 2,218 college students at a large university in the southwestern United States was conducted between August 2020 and December 2021. The sample was predominantly Hispanic (96%) and female (73%), with a mean age of 20.7 years. Standardized measures of adverse childhood experiences, recent stressful life events, perceived stress, and insomnia were administered to participants online. Almost 20% of participants reported having experienced four or more adverse childhood experiences and 63% met the threshold for insomnia. Reporting four or more ACEs was associated with significantly greater insomnia severity, and this relationship was serially mediated by both recent stressful life events and perceived stress. However, recent stressful life events appeared to be the most powerful mediator. The results of the current study indicate that recent exposure to stressful life events serves as a plausible mechanism linking early adversity during childhood to adult insomnia and could therefore serve as a potential target for intervention. The findings suggest that students would benefit from university-wide efforts to reduce the number and/or intensity of common stressors.

A scientometric review of the association between childhood trauma and sleep

Sleep is a complex state which involves interactions between neurophysiological, psychological and neurochemical processes which in turn have an important impact on brain functioning, immune responses, mental health, and quality of life. The incidence of Adverse Childhood Experiences (ACEs) varies across different countries and have been linked with lifespan sleep disturbances with further effects on people's physical and mental health functioning. This review aims to explore the significance of ACE and its impact on sleep by identifying key documents, thematic trends, and knowledge gaps in the literature. A document co-citation analysis of 882 documents from Scopus was conducted to achieve this goal. Research trends focused on the long-term consequences of childhood adverse events with respect to sleep, with emphasis on the role of type, timing and accumulation of these experiences. A recent study has also taken advantage of machine learning and network analysis for discovering essential factors could offer useful information about adults with history of childhood adversity and sleep problems. The studies show unanimously that ACEs are associated with multiple sleep disturbances/disorders which can persist into adulthood, with consequences for suboptimal cognitive and behavioral functioning. Such neurobiological scars can be associated with an increased risk of mental disorders. Future studies are needed that focus on longitudinal analysis of the relationship between early adversity, sleep, and resilience characteristics in adult populations exploring the use of objective assessment measures as well as neurobiological markers.

Associations among early life adversity, sleep disturbances, and depressive symptoms in adolescent females and males: a longitudinal investigation

BACKGROUND

Exposure to adversity early in life (ELA) has been associated with elevated risk for depression during adolescence, particularly for females; the mechanisms underlying this association, however, are poorly understood. One potential mechanism linking ELA and sex differences in depressive symptoms is sleep disturbances, which increase during adolescence and are more common in females. Here, we examined whether sleep disturbances mediate the association between ELA and increases in depressive symptoms during adolescence and whether this mediation differs by sex.

METHODS

224 (N = 132 females) youth were recruited at age 9-13 years and assessed every 2 years across three timepoints. At the first timepoint, we conducted extensive interviews about stressful events participants experienced; participants provided subjective severity ratings of events and we objectively scored the severity of each event. Self-reported sleep disturbances and depressive symptoms were assessed at all timepoints. We conducted linear mixed models to estimate both initial levels and changes in sleep disturbances and depressive symptoms, and moderated mediation analyses to test whether initial levels and/or changes in sleep disturbances mediated the association of ELA (objective and subjective) with increases in depressive symptoms across adolescence and whether the mediations differed by sex.

RESULTS

While higher initial levels and increases in sleep problems were uniquely associated with increases in depressive symptoms for males and females, they were related to ELA differently by sex. For females, greater ELA (both objectively and subjectively rated) was associated with higher initial levels of sleep problems, which in turn were associated with increases in depressive symptoms from early to late adolescence. In contrast, for males, ELA exposure was not associated with either initial levels of, or increases in, sleep problems.

CONCLUSIONS

These findings highlight the role of sleep disturbances during the transition to adolescence in mediating sex differences in the effects of ELA on depressive symptoms.