Abstract Introduction Adverse childhood experiences (ACEs) and sleep disturbances independently affect health and development across the lifespan. While burgeoning research suggests a link between ACEs and sleep health among adults, few studies have examined the association between ACEs and sleep in childhood or whether these associations vary by sex or race/ethnicity. Methods Using prospective data from 2,063 children (49% female; 20% Non-Hispanic [NH] White, 55% NH Black, 25% Hispanic/Latino) from the Fragile Families & Child Wellbeing Study, we used multiple linear regression analyses to examine associations between primary caregiver reports of child cumulative ACEs (i.e., physical abuse; emotional abuse; neglect; household dysfunction; possible range=0 to 10) at age 5 and primary caregiver reports of average sleep duration (minutes) at age 9. We used interaction terms to examine whether these associations varied by sex (reference group: males) or race/ethnicity (reference group: NH Whites). If significant, we used plots to visually investigate other potential between-groups differences (i.e. non-overlapping 95% CIs) and tested these statistically using linear combinations of estimator tests. If there were significant group differences, analyses were stratified by sex or race/ethnicity. Results Associations between ACEs and sleep duration significantly varied by race/ethnicity but not sex, such that the magnitude of the association was stronger in NH Whites compared to NH Blacks (p<.0001) and in Hispanics/Latinos compared to NH Blacks (p<.0001). In analyses stratified by race/ethnicity and adjusted for both sex and age 5 sleep duration, each unit increase in ACE score was associated with a 6.66 minute shorter sleep duration in NH Whites (B=-6.66, SD=2.10, p=0.002), a non-significant 2.20 minute shorter sleep duration in NH Blacks (B=-2.20, SD=1.52, p=0.148), and a 4.36 minute shorter sleep duration in Hispanics/Latinos (B=-4.36, SD=2.03, p=0.032). Conclusion We found that cumulative ACEs were associated with shorter sleep duration across race/ethnicity and more strongly related in NH White and Hispanic/Latino children. Prospective studies with subjective and objective sleep measures investigating multiple sleep parameters are needed that identify factors (e.g., cumulative disadvantage) that differentially affect associations across race/ethnicity and characterize health outcomes of ACEs and sleep duration. Support 5T32MH014592-39, 5T32DA007292-27, Z1A ES103325-01
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