Abstract Introduction Adverse Childhood Experiences (ACEs) are associated with a wide range of negative health outcomes, including sleep disturbance. Prior literature has identified stress as a pathway linking early experiences of adversity and poor sleep in clinical and community samples, often with comorbid psychiatric or sleep complaints. However, additional empirical research in healthy adults, without medical or psychiatric comorbidities, remains necessary to improve our understanding of the impact of stress in nonclinical populations. Methods Participants included 55 healthy adults aged 18–47 years (59% female; 40% white, 25% Black, 17.31% Asian, 17.31% Other). At baseline, participants completed the revised ACE questionnaire assessing exposure to adversity during childhood. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), and perceived stress was assessed with the Perceived Stress Scale (PSS). A mediation model tested whether perceived stress mediated the association between ACEs and sleep quality. Results Descriptive analyses indicated low levels of childhood adversity and sleep disturbance, with moderate perceived stress. The mean ACE score was 2.33 (SD = 2.06), the mean PSQI global score was 2.93 (SD = 1.99), and the mean PSS score was 9.56 (SD = 5.55). Higher ACE scores were significantly associated with greater perceived stress (b = 0.83, SE = 0.35, p = .023). Perceived stress, in turn, predicted poorer sleep quality (b = 0.18, SE = 0.05, p .001). The direct effect of ACEs on sleep quality was nonsignificant when controlling for stress (b = –0.01, SE = 0.12, p = .95). The indirect effect of ACEs on sleep quality through perceived stress was significant (b = 0.15, Bootstrapped SE = 0.06, 95% Bootstrapped CI 0.05, 0.31), indicating full mediation. Conclusion Among healthy adults without clinical sleep problems, psychiatric or medical conditions, exposure to childhood adversity is indirectly linked to poorer sleep quality through higher perceived stress. These findings highlight perceived stress as an important psychological mechanism underlying the influence of ACEs on sleep. Future longitudinal studies should examine whether stress-related arousal processes contribute to the progression from early adversity to chronic sleep disturbance and related health outcomes. Support (if any) NIH/NHLBI 1U01 HL150568 (MTS)
Weinman et al. (Fri,) studied this question.