Associations of adverse and positive childhood experiences with self-reported difficulty sleeping among urban caregivers in Philadelphia, Pennsylvania

Objective: Adequate sleep is essential for health and cognition, yet a third of adults in the United States report trouble sleeping. Adverse childhood experiences (ACEs) have been identified as a predictor of sleep problems in adulthood, but there is little research on countervailing childhood exposures that may improve sleep or ameliorate the effects of ACEs. We addressed this gap by examining how past positive childhood experiences (PCEs) and ACEs are associated with difficulty sleeping. Methods: = 435) of children in Philadelphia, Pennsylvania. We used survey-weighted, covariate-adjusted Poisson regression to evaluate separate and joint associations of self-reported high ACEs and PCEs with difficulty sleeping. Results: High ACEs were associated with higher adjusted prevalence of difficulty sleeping (aPR = 1.34 [1.14-1.58]). This association was attenuated after adjustment for high PCEs (aPR = 1.20 [1.02-1.43). High PCEs were associated with lower prevalence of difficulty sleeping after adjustment for ACEs and other covariates (aPR = 0.77 [0.64-0.93]). There was no evidence of interaction between high ACEs and high PCEs. Conclusions: Results provide evidence for a positive association of PCEs on adult sleep despite ACEs, highlighting the importance of a life course approach to understanding adult sleep.