Adverse childhood experiences and sleep difficulties among young adult college students

Abstract

Although adverse childhood experiences (traumatic events such as maltreatment and household dysfunction) are associated with increased risk for sleep difficulties among adults, the association between adverse childhood experiences and poor sleep health among young adult college populations is understudied. This study examined the adverse childhood experience-sleep health (self-reported sleep difficulty and diagnosis of insomnia or "other" sleep disorder) association among college students. Data are from the 2018/2019 American College Health Association-National College Health Assessment II (ACHA-NCHA-II) survey administered at public universities in California (n = 3606) and Texas (n = 407). Logistic regression models investigated the relative effect of adverse childhood experiences (maltreatment only, household dysfunction only, and maltreatment + household dysfunction) on three sleep health indicators. Approximately 40% of the sample reported adverse childhood experiences: 11% maltreatment only, 14% household dysfunction only, and 17% both. Compared with students with no adverse childhood experience history, students who reported only household dysfunction or only maltreatment had higher odds of experiencing sleep difficulty in the past year [adjusted odds ratios: 1.52-2.40; 95% confidence intervals: 1.26-2.97]. Additionally, students who reported maltreatment only had 2.47 times the odds of receiving an insomnia diagnosis [95% confidence interval: 1.52, 4.01]. However, students who reported both had higher odds of all three sleep health indicators: past-year sleep difficulty, insomnia diagnosis, and "other" sleep disorder diagnosis [adjusted odds ratios: 2.53-3.10; 95% confidence intervals: 1.51-4.66]. Sleep is an important facet of health among the college student population, and plays a crucial role in overall well-being, psychosocial processes, attention and academic success. Results point toward a need for sleep health programmes and interventions on college campuses focused on healthy sleep behaviours in order to mitigate further negative health effects.

Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

“…Expanding on prior studies of ACE and adult sleep problems [ 11 – 14 ], our findings support the notion that ACE has a lasting negative impact on sleep, particularly contributing to persistent insomnia in emerging adults. Consistent with the theory of trauma-induced chronic insomnia [ 17 , 18 ], a state of sustained hyperarousal serves as the primary mechanism by which adults who have experienced severe early adversity develop a fear of sleep that subsequently leads to persistent insomnia.…”

“…Moreover, our third hypothesis was confirmed, illustrating that the protective influence of PCE on later persistent insomnia was impeded when ACE experiences were excessive, consistent with the challenge model. Expanding on prior studies of ACE and adult sleep problems [11][12][13][14], our findings support the notion that ACE has a lasting negative impact on sleep, particularly contributing to persistent insomnia in emerging adults. Consistent with the theory of trauma-induced chronic insomnia [17,18], a state of sustained hyperarousal Early adolescence in this study was defined as the period when the subjects were around 14 years old serves as the primary mechanism by which adults who have experienced severe early adversity develop a fear of sleep that subsequently leads to persistent insomnia.…”

“…Adverse childhood experiences (ACE) have been shown to have traumatic and lasting effects on health and behavior across the lifespan [9,10]. An increased likelihood of poor sleep quality, sleep disruption, and psychiatric sleep disorders in adulthood has been found to be associated with ACE [11][12][13][14]. Early stressful life events in ACE research were initially focused only on the family context (i.e., abuse, neglect, and family dysfunction) [15] and have recently been expanded to encompass school and community contexts (i.e., peer victimization, peer isolation, and community violence) [16].…”

“…Early stressful life events in ACE research were initially focused only on the family context (i.e., abuse, neglect, and family dysfunction) [15] and have recently been expanded to encompass school and community contexts (i.e., peer victimization, peer isolation, and community violence) [16]. Although numerous studies have found a link between ACE and sleep disturbances [11][12][13][14], few have investigated persistent insomnia. According to the theory of trauma-induced chronic insomnia [17,18], traumatic events trigger hyperarousal, resulting in immediate insomnia symptoms.…”

Adverse childhood experiences and sleep links in a predominantly Black sample of overweight adults

“…Future research in larger samples with a broader range of racial/ethnic minority groups represented are needed to examine potential racial/ethnic disparities in the relationship between ACEs and sleep more broadly, given the sparse data in this area (Albers et al., 2022; Gaston et al., 2020; Rojo‐Wissar et al., 2021). Future studies should also include measures of discrimination and measures of SES (i.e., education, income, and occupation), which may interact with ACEs to affect sleep among racial/ethnic minorities or account for racial/ethnic disparities in the ACEs‐sleep relationship (Cheng et al., 2020; Johnson et al., 2019b).…”