Department of Epidemiology, Emory University Rollins School of Public Health, Emory University School of Medicine MD Program, Atlanta, Georgia.
Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey.
JAMA Netw Open. 2024 Apr 1;7(4):e247532. doi: 10.1001/jamanetworkopen.2024.7532.
Sleep quality is a known marker of overall health. Studies suggest that adverse childhood experiences (ACEs) are associated with sleep disturbances among children and adults.
To examine the association of retrospective and prospective ACEs with sleep quality among a cohort of Puerto Rican young adults from 2 sociocultural contexts.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study used data from the Boricua Youth Study (BYS), a population-based study representing Puerto Rican children from the South Bronx, New York, and Puerto Rico conducted from August 2000 to August 2003. Participants who were 5 to 9 years of age at enrollment in the BYS and who participated in wave 4 of the BYS took part in the Health Assessment (HA) when they were 18 to 29 years of age, from April 2013 to August 2017. Of the eligible 982 participants, 813 (82.8%) participated in the HA. Statistical analysis was conducted from January 2023 to January 2024.
Prospective ACEs measured from parent and youth responses and retrospective ACEs measured among young adults using questions from the validated ACE questionnaire from the original ACEs study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention and published in 1998. Analysis included 8 overlapping items from both questionnaires.
Sleep quality was assessed in the HA with the Pittsburgh Sleep Quality Index. The summary score included 7 components of the Pittsburgh Sleep Quality Index. The hypothesis was formulated after data collection. Sleep quality information was gathered at the same time as retrospective ACEs in the HA.
Of the 813 participants, 438 (53.9%) lived in Puerto Rico as children, 411 (50.6%) identified as female, and the mean (SE) age of participants was 22.9 (0.07) years. After adjusting for sociodemographic factors, retrospective ACEs had a significant association with worse sleep outcomes (β [SE] = 0.29 [0.07]; 95% CI, 0.15-0.44; P < .001). Prospective ACEs did not have a significant association with sleep quality, after adjusting for sociodemographic factors (β [SE] = 0.05 [0.10]; 95% CI, -0.14 to 0.24; P = .59).
This study suggests that there is a significant association between retrospective ACEs and sleep quality among Puerto Rican young adults, after adjusting for sociodemographic factors. Prospective ACEs were not significantly associated with sleep disturbances, after adjusting for sociodemographic factors. Addressing ACEs reported in young adulthood may help reduce sleep disorders.
睡眠质量是整体健康的已知标志。研究表明，不良的童年经历 (ACEs) 与儿童和成人的睡眠障碍有关。
在来自两个社会文化背景的波多黎各年轻成年人队列中，检查回顾性和前瞻性 ACEs 与睡眠质量的关联。
设计、地点和参与者：这项前瞻性队列研究使用了波多黎各青年研究 (BYS) 的数据，该研究是一项基于人口的研究，代表了来自纽约南布朗克斯的波多黎各儿童和波多黎各的儿童，研究时间为 2000 年 8 月至 2003 年 8 月。在 BYS 登记时年龄在 5 至 9 岁并参加了 BYS 的第 4 波的参与者在 18 至 29 岁时参加了健康评估 (HA)，时间为 2013 年 4 月至 2017 年 8 月。在符合条件的 982 名参与者中，有 813 名（82.8%）参加了 HA。统计分析于 2023 年 1 月至 2024 年 1 月进行。
前瞻性 ACEs 是通过父母和年轻人的反应测量的，回顾性 ACEs 是通过年轻人在 HA 中使用 Kaiser Permanente 和疾病控制与预防中心在 1998 年进行的原始 ACEs 研究中使用的有效 ACE 问卷测量的。分析包括来自两个问卷的 8 个重叠项目。
在 HA 中使用匹兹堡睡眠质量指数评估睡眠质量。综合评分包括匹兹堡睡眠质量指数的 7 个组成部分。该假设是在数据收集后提出的。睡眠质量信息与 HA 中的回顾性 ACEs 同时收集。
参与者中有 438 名（53.9%）在波多黎各长大，411 名（50.6%）为女性，参与者的平均（SE）年龄为 22.9（0.07）岁。在调整了社会人口因素后，回顾性 ACEs 与较差的睡眠结果有显著关联（β [SE] = 0.29 [0.07]；95%CI，0.15-0.44；P < 0.001）。在调整了社会人口因素后，前瞻性 ACEs 与睡眠质量没有显著关联（β [SE] = 0.05 [0.10]；95%CI，-0.14 至 0.24；P = 0.59）。
这项研究表明，在调整了社会人口因素后，波多黎各年轻成年人的回顾性 ACEs 与睡眠质量之间存在显著关联。在调整了社会人口因素后，前瞻性 ACEs 与睡眠障碍没有显著关联。在年轻成年人中报告的 ACEs 可能有助于减少睡眠障碍。
