Quantity, timing, and type of childhood adversity and sleep quality in adulthood

Objective: We investigated how quantity, timing, and type of childhood adversity were associated with subjectively reported and actigraphically measured sleep in adulthood. Design: This is a cross-sectional design. Setting: Data were collected from three clinical sites at the University of California, Los Angeles; the University of Wisconsin–Madison; and Georgetown, in the Washington, DC area. Participants: The participants were a group of 863 U.S. adults aged 25–76 years who participated in the Biomarker Project in the Midlife in the United States Refresher study. Measurement: Subjective sleep was measured by the Pittsburgh Sleep Quality Index and actigraphic sleep measures included sleep-onset latency, sleep efficiency, wake time after sleep onset, and total sleep time. Participants retrospectively reported whether they experienced 18 adverse events before age 18 years and the ages they experienced the events. Results: Childhood adversity, operationalized as quantity (i.e., the total number of adverse events or experiencing 3 or more adverse events) and timing (i.e., experiencing adverse events during both childhood and adolescence) of adverse events, was related to worse subjective and actigraphic sleep (except for total sleep time) after adjusting for age, sex, and race. Models using the cumulative (i.e. dose-response) number of adverse events fit better than models using the timing and type specifications of childhood adversity in relation to subjective or actigraphic sleep measures (except for total sleep time). Conclusions: These findings highlight the importance of considering the quantity of childhood adversity in relation to self-reported and actigraphically measured sleep in adulthood.