Abstract MP46: Adverse Childhood Experiences Are Linked To Disrupted Sleep And Diurnal Cortisol Concentrations In Young Adult Women.

Abstract

Introduction: Early life psychosocial stress and adversity - referred to as adverse childhood experiences (ACEs) - are highly prevalent, with ~60% of American adults reporting exposure to at least one ACE. ACEs occur during critical developmental periods and are related to cardiovascular morbidity and mortality in a graded, dose-dependent manner. Sleep is an emerging lifestyle behavior that has been associated with cardiometabolic morbidity and mortality, and poor sleep has been associated with ACEs. Hypothesis: We hypothesized that ACEs would be associated with disrupted sleep and altered diurnal cortisol slopes in young adult women. Methods: Forty-two young adult women (mean ± SD, age = 21 ± 3 y) completed this study. Twenty-eight women reported an ACE score ≥4 and were classified as having moderate to severe ACEs, while 14 women reported an ACE score of 0. Women provided saliva samples collected using the passive drool technique upon waking and 8 h later. Cortisol concentrations were then quantified from the saliva samples by ELISA and diurnal cortisol slopes (DCS) were calculated by expressing the difference between morning and afternoon concentrations relative to the time between sampling (μg/dL/h). The participants also completed the Center for Epidemiologic Studies Depression Scale Revised (CESD-R), from which a composite sleep score (CSS; range = 0 - 12) was created from the three sleep-related items and reverse-scored such that a higher score indicated better sleep. Women also completed the Maltreatment and Abuse Chronology of Exposure Scale, from which a total maltreatment and abuse severity score was calculated (MACE TSS ). Mann-Whitney tests were used to examine differences in DCS and CSS between those with versus without a history of ACEs. Median values are reported. Spearman correlations were used to examine associations among DCS, CSS, and MACE TSS . Results: DCS was greater (-0.0396 vs. -0.0661 μg/dl/h; U = 94, p = 0.01), indicating lower variability, and CSS was lower (5 vs. 7; U = 118.5, p = 0.04), indicating poorer sleep, in the women with versus without a history of ACEs. Further, MACE TSS was related to DCS (ρ = 0.397, p = 0.007) and to CSS (ρ = -0.358, p = 0.011). The relationship between DCS and CSS (ρ = -0.218, p = 0.092) was not significant. Conclusions: Our preliminary evidence indicates that ACEs are associated with poorer sleep and disrupted diurnal cortisol patterns. While we are limited by subjective sleep assessments and small sample size, these findings suggest a link between early life psychosocial stress, poor sleep and circadian disruption that could contribute to lifetime cardiometabolic disease risk. Future, large-scale studies are needed to further explore these associations.