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Sleep Med. 2011 Sep;12(8):773-9. doi: 10.1016/j.sleep.2011.03.013. Epub 2011 Jun 24.

Adverse childhood experiences and sleep disturbances in adults.

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Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States.



Sleep disturbances are associated with an increased risk for many chronic diseases and unhealthy behaviors. A history of adverse childhood experiences (ACEs) is also associated with similar adult health outcomes. We studied the relationship between multiple ACEs and the likelihood of experiencing self-reported sleep disturbances in adulthood.


We used data from the adverse childhood experiences (ACE) study, a retrospective cohort study of 17,337 adult health maintenance organization members in California who completed a survey about eight ACEs, which included childhood abuse and growing up with various forms of household dysfunction. The self-reported sleep disturbances measured included ever having trouble falling or staying asleep and feeling tired after a good night's sleep. We used an integer count of the number of ACEs (the ACE score) to assess the cumulative impact of these experiences on the likelihood of self-reported sleep disturbances.


Thirty-three percent of the cohort reported trouble falling or staying asleep, while 24% reported feeling tired after sleeping. All eight ACE categories were associated with an increased likelihood of self-reported sleep disturbances (p<0.05). Compared to persons with an ACE score of 0, those with an ACE score ≥ 5 were 2.1 (95% CI: 1.8-2.4) times more likely to report trouble falling or staying asleep and 2.0 (95% CI: 1.7-2.3) times more likely to report feeling tired even after a good night's sleep. The trend for increasing odds for both types of self-reported sleep disturbance with increasing ACE scores was statistically significant (p<0.0001).


Adverse childhood experiences were associated with self-reported sleep disturbances in adulthood, and the ACE score had a graded relationship to these sleep disturbances. A history of ACEs should be obtained for patients with self-reported sleep disturbances to coordinate services that ameliorate the long-term effects of these events.

[Indexed for MEDLINE]

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