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Accepted manuscript

Sleep It Off? Exploring Sleep Duration and Bedtime Regularity as Potential Moderators of Early Adversity’s Impact on Mental Health in Infancy, Childhood, and Adolescence

Published online by Cambridge University Press:  10 April 2025

Sarah L. H. Kamhout Open the ORCID record for Sarah L. H. Kamhout [Opens in a new window]  and
Kara McRae Duraccio Open the ORCID record for Kara McRae Duraccio [Opens in a new window]
Sarah L. H. Kamhout*
Affiliation:
Psychology Department, Brigham Young University, 227 TLRB, Provo, UT, United States, 84602
Kara McRae Duraccio
Affiliation:
Psychology Department, Brigham Young University, 227 TLRB, Provo, UT, United States, 84602
*
Corresponding Author: Sarah Kamhout, [email protected], 227 TLRB, Provo, UT, United States, 84602, 801-422-2314
Rights & Permissions [Opens in a new window]

Abstract

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Introduction:

Adverse Childhood Experiences (ACEs) are known to increase risk of mental health challenges, and sleep is known to decrease risk. We investigated whether adequate sleep duration and sleep regularity would moderate the impact of ACE exposure on mental health risk.

Methods:

We conducted secondary cross-sectional analyses on the 2020-2021 waves of the National Survey of Children’s Health (NSCH; N = 92,669). Logistic and ordinal regressions explored impact of ACEs (total, household, community, and single) and sleep (duration and irregularity) and related interactions on mental health diagnosis and symptom severity.

Results:

Known main effects for ACEs and sleep on mental health were replicated. Interactions between ACE exposure and sleep factors were not clinically significant, although some were statistically significant due to large sample, such that adequate duration was associated with marginally increased risk of mental health diagnosis (Omnibus B = 0.048, p < 0.0001) and greater bedtime irregularity was associated with marginally decreased risk (Omnibus B = -0.030, p < 0.001).

Discussion:

Dichotomous and categorical assessments of sleep health may not be sensitive to interaction effects, compared with continuous data. Examining mental health symptoms (rather than diagnosis status) may also allow for nuanced understanding of potential interactions.

Keywords

Sleep regularitysleep durationadverse childhood experiencesfamily resilience
Type
Results
Information
Research Directions: Sleep Psychology , Accepted manuscript , pp. 1 - 34
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2025. Published by Cambridge University Press