Nonrestorative sleep mediates the influence of Adverse Childhood Experiences on psychological distress, physical health, mental health, and activity limitation: A longitudinal study for the general population in Japan

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-06-30 DOI:10.1016/j.sleep.2025.106658

Megumi Hazumi , Kentaro Matsui , Takahiro Tabuchi , Ryo Okubo , Takuya Yoshiike , Shingo Kitamura , Aoi Kawamura , Kentaro Nagao , Tomohiro Utsumi , Muneto Izuhara , Jun Kizuki , Momo Fushimi , Daisuke Nishi , Kenichi Kuriyama

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引用次数: 0

Abstract

Background

Adverse childhood experiences (ACEs) refer to traumatic events faced by children and adolescents, such as abuse, violence, and neglect. The longitudinal mediation effects of ACEs on mental health, physical health, and activity, particularly using nonrestorative sleep (NRS), a subjective perception of unrefreshing sleep, remain unclear. Thus, this study aimed to investigate the mediating role of NRS in the relationships between ACEs and subsequent health problems and daytime inactivity in adulthood.

Methods

Using data from the Japan COVID-19 and Society Internet Survey, we conducted a longitudinal study with mediation analysis. Psychological distress (K6 ≥ 13), physical and mental health problems, and daytime inactivity (Health-Related Quality of Life-4; all defined as ≥14 days/month), NRS (≥16 days/month), and ACEs (≥4 items from a validated ACEs list) were assessed.

Results

Among the 17,042 participants, 52.8 % were male, with a mean age of 50.35 years (SD = 17.73). Significant mediational pathways via NRS were observed from ACEs to psychological distress (RR = 1.14, 95 % CI = 1.08–1.19, p < 0.001), physical health problems (RR = 1.30, 95 % CI = 1.21–1.40, p < 0.001), mental health problems (RR = 1.20, 95 % CI = 1.13–1.28, p < 0.001), and daytime inactivity (RR = 1.27, 95 % CI = 1.17–1.37, p < 0.001). Conclusions: Our findings demonstrated that NRS mediated the impact of ACEs on mental and physical health issues and daytime inactivity, suggesting sleep quality as a potential target for mitigating early life adversity.

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非恢复性睡眠介导不良童年经历对心理困扰、身体健康、心理健康和活动限制的影响：一项针对日本普通人群的纵向研究

童年不良经历（ace）是指儿童和青少年所面临的创伤性事件，如虐待、暴力和忽视。ace对心理健康、身体健康和活动的纵向中介效应，特别是使用非恢复性睡眠（NRS），一种对不提神睡眠的主观感知，尚不清楚。因此，本研究旨在探讨NRS在ace与随后的健康问题和成年期日间缺乏活动之间的关系中的中介作用。方法利用日本COVID-19和社会互联网调查数据，采用中介分析进行纵向研究。心理困扰（K6≥13）、身心健康问题和日间缺乏活动（健康相关生活质量）；所有定义为≥14天/月)，NRS（≥16天/月）和ace（≥4项验证的ace清单）进行评估。结果在17042名参与者中，52.8%为男性，平均年龄50.35岁（SD = 17.73）。通过NRS观察到从ace到心理困扰的显著中介通路(RR = 1.14, 95% CI = 1.08-1.19, p <；0.001),身体健康问题(RR = 1.30, 95% CI -1.40 = 1.21, p & lt;0.001),心理健康问题(RR = 1.20, 95% CI -1.28 = 1.13, p & lt;0.001),白天不活动(RR = 1.27, 95% CI -1.37 = 1.17, p & lt;0.001)。结论：我们的研究结果表明，NRS介导了ace对心理和身体健康问题以及白天缺乏活动的影响，表明睡眠质量是减轻早期生活逆境的潜在目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.