Nonrestorative sleep mediates the influence of Adverse Childhood Experiences on psychological distress, physical health, mental health, and activity limitation: A longitudinal study for the general population in Japan.

BACKGROUND

Adverse childhood experiences (ACEs) refer to traumatic events faced by children and adolescents, such as abuse, violence, and neglect. The longitudinal mediation effects of ACEs on mental health, physical health, and activity, particularly using nonrestorative sleep (NRS), a subjective perception of unrefreshing sleep, remain unclear. Thus, this study aimed to investigate the mediating role of NRS in the relationships between ACEs and subsequent health problems and daytime inactivity in adulthood.

METHODS

Using data from the Japan COVID-19 and Society Internet Survey, we conducted a longitudinal study with mediation analysis. Psychological distress (K6 ≥ 13), physical and mental health problems, and daytime inactivity (Health-Related Quality of Life-4; all defined as ≥14 days/month), NRS (≥16 days/month), and ACEs (≥4 items from a validated ACEs list) were assessed.

RESULTS

Among the 17,042 participants, 52.8 % were male, with a mean age of 50.35 years (SD = 17.73). Significant mediational pathways via NRS were observed from ACEs to psychological distress (RR = 1.14, 95 % CI = 1.08-1.19, p < 0.001), physical health problems (RR = 1.30, 95 % CI = 1.21-1.40, p < 0.001), mental health problems (RR = 1.20, 95 % CI = 1.13-1.28, p < 0.001), and daytime inactivity (RR = 1.27, 95 % CI = 1.17-1.37, p < 0.001).

CONCLUSIONS

Our findings demonstrated that NRS mediated the impact of ACEs on mental and physical health issues and daytime inactivity, suggesting sleep quality as a potential target for mitigating early life adversity.