0061 Associations Between Sleep, Adverse Childhood Experiences and High Body Mass Index in a National Sample of Adolescents

Abstract

Abstract Introduction Adverse childhood experiences (ACEs) are independently associated with short sleep duration (SD) and an increased obesity risk that tracks into adulthood. Similarly, substantial research has demonstrated an association between deficient sleep and overweight/obesity in adolescents. Not known is how sleep duration and ACEs may interact in association with obesity risk in adolescents. This study explored ACEs as a moderator between sleep duration and obesity risk in a national sample of adolescents. Methods Using the National Survey of Children’s Health 2017-2018 dataset, we included adolescents (10-17 yrs) with available SD and Body Mass Index (BMI) data. Parents reported adolescent’s SD, and number of ACEs. We classified adolescents as overweight/obese if they had a BMI ≥85th percentile. Using a stepwise approach and accounting for complex survey design, logistic regression (STATA 16.0) estimated the interaction between SD and the number of ACEs in adolescents, controlling for selected covariates (i.e., demographics, social determinants, sleep regularity, exercise, and mental/physical health outcomes). Results In a sample of 26,013 adolescents (mean age=13.81, SD=2.29; 52% male, 70% White, Non-Hispanic), 27% were classified as overweight/obese, 47% had >1 ACE, and 34% had SD <8-10 hours/night. Accounting for covariates and ACEs, every hour increase in SD was associated with 6% decrease in the odds of overweight/obesity (OR=0.94, p=0.04). There was a significant interaction between SD and ACEs. Compared with having no ACEs, the association between longer sleep and lower odds of high BMI was weakened or even reversed if an adolescent experienced one ACE (OR=1.18, p=0.02) or two or more ACEs (OR=1.13, p=0.04). Conclusion Adolescence may be a critical period in the life course for the interaction between SD and ACEs on obesity risk. Increasing SD is a known intervention target to decrease obesity risk, yet in children experiencing one or more ACE, this protective role may be dampened. Our results suggest that sleep and cardiometabolic intervention efforts should target adolescents who may be living within risky childhood environments. Support (If Any) None.