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May 10, 2026SLEEP0 citations

0149 Adverse Childhood Experiences and PSG Measured Physiological Hyperarousal During Sleep

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DRDarlynn Rojo-WissarHLHatty LaraMNMelissa Nevarez-Brewster

Key Points

  • This research investigates the relationship between adverse childhood experiences (ACEs) and physiological hyperarousal during sleep.
  • Participants were 54 healthy adults aged 18 to 47, evaluated using polysomnography (PSG).
  • Participants reported ACE exposure via a revised ACE survey.
  • Regression models were used to analyze associations controlling for age, sex, income, and race/ethnicity.
  • Each unit increase in ACE score led to a 2.38 unit increase in average heart rate during sleep (SE=0.79, p=0.005).
  • Each unit increase in ACE score resulted in a 1.30 unit rise in the arousal index during sleep (SE=0.47, p=0.009).
  • No significant associations were found for sleep onset latency, wake after sleep onset, sleep efficiency, or heart rate standard deviation.

Abstract

Abstract Introduction Adverse Childhood Experiences (ACEs) are robustly associated with poorer subjective sleep quality and trouble falling and staying asleep, with elevated nocturnal hyperarousal proposed as a key mechanism. Hyperarousal is a state of heightened physiological activation that can disrupt restorative sleep and increase the risk of developing long-term health issues. However, empirical studies examining the links between ACEs and objective measures of nighttime hyperarousal are lacking. To address this gap, we examined associations between cumulative ACE exposure and polysomnography (PSG) derived measures of hyperarousal during sleep among a nonclinical sample of adults. Methods Participants were 54 healthy adults aged 18 to 47 (59% female; 40% white, 25% Black, 17. 31% Asian, 17. 31% Other). Annual household income ranged from ≤34, 999 (32. 65%) to ≥75, 000 (32. 65%). At their first visit, participants completed the revised ACE survey, reporting exposure to 18 different types of adversity before the age of 18, such as abuse, neglect, and household dysfunction. At a separate visit, physiological hyperarousal indicators (sleep onset latency SOL, wake after sleep onset WASO, sleep efficiency SE, arousal index, and the mean and standard deviation of heart rate (HR) during sleep) were derived from a single night of in-lab PSG. Regression models controlling for age, sex, income, and race/ethnicity were used to examine associations between revised ACE score and each hyperarousal indicator. Results Each unit increase in ACE score was associated with a 2. 38 unit increase in average HR during sleep (standard error SE=0. 79, p=. 005), and a 1. 30 unit increase in the arousal index during sleep (SE=0. 47, p=. 009). ACEs were not significantly associated with SOL, WASO, SE, or the standard deviation of HR during sleep. Conclusion Even among healthy adults free from mental or physical health issues, including sleep problems, ACEs are linked to objective markers of nocturnal hyperarousal. Future prospective studies should examine whether elevated nocturnal hyperarousal mediates associations between ACEs and the later development of poor health outcomes, including among adults who are initially healthy. Support (if any) P20GM139767; U01 HL150568-01

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Cite This Study

Rojo-Wissar et al. (2026) studied this question.

synapsesocial.com/papers/6a0020cec8f74e3340f9bad2https://doi.org/10.1093/sleep/zsag091.0149
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