The influence of cumulative and dimensional childhood adversity on maternal sleep quality.

Abstract

This cross-sectional study examined the extent to which cumulative and specific dimensions-threat and deprivation-of adverse childhood experiences (ACEs) are associated with sleep quality in postpartum mothers. Eighty-seven mothers of infants completed assessments on sociodemographic characteristics, ACEs, and sleep quality. The sample was 39.1% White, 21.8% Latina, 16.1% Black/African American, 10.3% more than one race, 4.6% Asian, 4.6% American Indian/Alaskan Native, 2.4% unspecified race/ethnicity, and 1.1% Pacific Islander. An exploratory factor analysis was computed in which ACEs were categorized as dimensions of threat (i.e., experiencing harm or threat of harm) or deprivation (i.e., an absence of cognitive and social inputs). Separate generalized linear models were conducted to examine (a) cumulative ACEs and (b) threat and deprivation dimensions of ACEs in relation to maternal sleep quality scores on the Pittsburgh Sleep Quality Index (PSQI); higher PSQI scores indicate worse sleep quality. Likelihood ratio tests were conducted to compare if there were significant differences in model fit between the threat and deprivation model versus the cumulative ACEs model. Cumulative ACEs were positively associated with global PSQI scores. Threat, but not deprivation, was positively associated with global PSQI scores. The difference in variance explained between the two models was not statistically significant. The present study highlights the utility of dimensional models of adversity in conjunction with the cumulative ACEs model to identify more nuanced relationships between early adversity and maternal sleep outcomes. This approach may advance research on more targeted interventions during the postpartum period. (PsycInfo Database Record (c) 2025 APA, all rights reserved).