Adverse childhood experiences and sleep duration among US 65 years and older: results from the 2020 BRFSS

Background: Adverse childhood experiences (ACEs) are a risk factor for many chronic diseases and health behaviors. This study explores the relationship between ACEs and sleep duration in elderly populations in 22 U.S. states in 2020.Methods: This study is a cross-sectional analysis of aged 65 years or older in the 2020 Behavioral Risk Factor Database (BRFSS). The weighted multivariate logistic regression was used to assess the association of ACEs status, ACEs type, and ACE scores with sleep duration. Subgroup analysis was used to estimate differences based on covariates.Results: Among the 42,786 participants (55.8 % female) included in this analysis, 50.5 % reported at least one ACE, and 7.3 % reported 4 or more ACEs. Adjusting for confounding factors, experiencing ACEs was associated with short and long sleep duration (Odds Ratio (OR): 2.03, 95 % Confidence Interval (CI): 1.51,2.73; OR:1.78, 95%CI:1.34,2.36). Older adults who experienced sexual abuse in children were 146 % more likely to short sleep (OR:2.46,95%CI:1.84,3.31) and 99 % more likely to long sleep (OR:1.99, 95%CI:1.35,2.92). There was a doseresponse gradient between ACEs scores and sleep duration, reporting >= 4 ACEs had 3.10 (OR:3.10,95% CI:2.12,4.53) and 2.13 (OR:2.13, 95%CI:1.33,3.40) times the risk for short-sleep and long-sleep duration compared to respondents reporting no ACEs.Conclusions: This study showed the association between ACEs and a high risk of sleep duration, which increased with increasing ACEs scores.