The Mediating Role of Sleep Duration in the Association Between Adverse Childhood Experiences and Depressive Symptoms Among Middle-Aged and Older Chinese Adults: A Nationwide Longitudinal Study

Abstract

Objectives

Examine longitudinal mediation of sleep duration between adverse childhood experiences (ACEs) and depressive symptoms in middle-aged and older adults.

Methods

We analyzed data from six waves (2011, 2013, 2014, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study (CHARLS) using parallel process Latent Growth Curve modeling.

Results

Higher ACEs were associated with shorter initial sleep (β_iSD = −0.064), and higher initial depressive symptoms (β_iDEP = 0.111). Mediation analysis revealed that shorter initial sleep duration indirectly linked higher ACEs to both a higher initial level of depressive symptoms (β = 0.027) and a faster increase in depressive symptoms over time (β = −0.017). Mediation via initial sleep was stronger for deprivation-related ACEs (28.0%) than threat-related (16.4%).

Conclusions

ACEs are linked to shorter initial sleep duration and a higher risk of depressive symptoms. Initial sleep partially mediates these associations. Increasing sleep may alleviate depressive symptoms in ACEs-exposed individuals.

Keywords

adverse childhood experiences depressive symptoms sleep duration middle-aged and older adults

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