Adverse childhood experiences and risk of chronic sleep disturbances: A population-based cohort study from a Chinese national survey

Abstract Background Adverse childhood experiences (ACEs) have long-lasting effects in Chinese older adults. Using China Health and Retirement Longitudinal Study (CHARLS) data, we examined ACEs’ impact on chronic sleep disturbances combining poor sleep quality and abnormal duration in China’s aging population. Methods We analyzed 20,450 CHARLS participants (2014 baseline). After excluding those with missing ACEs data (n = 11,006), incomplete sleep data, or aged 9 hours). Multivariable logistic regression adjusted for age, sex, education, marital status, smoking, drinking, and chronic diseases, with trend tests modeling ACEs ordinally. Results A graded association emerged: adjusted ORs increased from 1.30 (95% CI: 1.05–1.59) for 1 ACE to 2.1 (1.69–2.62) for ≥3 ACEs (Ptrend Conclusions Childhood adversity, particularly household mental illness, was significantly associated with sleep disturbances in older adults. The observed 2.1-fold prevalence difference suggests that older adults with high ACE exposure may benefit from targeted screening and early intervention.