Positive Childhood Experiences Can Moderate the Impact of Adverse Childhood Experiences on the Developmental Trajectory of Sleep Quality Among Adolescents

The effects of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) and its interactions on the development of sleep quality in adolescents were unclear. To investigate the effect of ACEs and PCEs on the developmental trajectories of sleep quality in adolescents and to examine the potential moderating role of PCEs on the effects of ACEs. This study was conducted based on Anhui Child & Adolescent Healthy Growth Cohort. Latent class growth analysis (LCGA) was applied to capture the developmental trajectory of sleep quality. Logistic regression analyses were conducted to determine the effects of ACEs and PCEs exposure on sleep quality trajectories. Interaction analyses were performed to explore the moderating role of PCEs on the impact of ACEs. A total of 877 adolescents were included in this study (mean age: 11.31 ± 1.63, 51.1% were boys). Adolescents with ACEs exposure showed higher risk of poor development of sleep quality and there was a positive dose-response relationship. Adolescents with a pattern of 'high ACE levels' exposure (OR: 3.74, 95% CI: 2.02-6.91) were more likely to experience poor sleep quality development. In contrast, adolescents with a pattern of 'high PCE levels' (OR: 0.50, 95% CI: 0.31-0.80) were less likely to experience poor sleep quality development. Moderate to high levels of PCEs exposure (3-7 PCEs) can significantly moderate the adverse effects of ACEs on sleep quality development. This study suggests that ACEs exposure adversely affects the development of sleep quality among adolescents, while PCEs can moderate this effect. These findings highlight the urgency of early screening and intervention for ACEs and emphasise the importance of implementing various strategies in early life to promote PCEs.