Peer-reviewed article
Influence of ACEs on Sleep Health in Early Childhood as Mediated by Family Routines.
Johnson AH, Davis SL, Phillipi D, Ahmadi M, Armstrong A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how adverse childhood experiences (ACEs) affect sleep health in preschool children aged 3-5 years, using data from the 2023 National Survey of Children's Health. The researchers found that family interaction habits—particularly reading aloud and family meals—can reduce the negative effects of ACEs on children's bedtime consistency and sleep duration. Two-thirds of parents reported their children got adequate sleep, and most children had daily outdoor play. The findings suggest that strengthening family routines may help protect children's sleep health even when they experience adverse circumstances.
Key points
- 66% of parents reported adequate child sleep; 89% reported consistent bedtimes
- 71% of families reported no ACEs; most children had one or more hours of outdoor play daily
- Reading aloud and family meals mediated the negative effects of ACEs on consistent bedtime
- Reading aloud and singing/storytelling mediated the effects of ACEs on adequate sleep duration
- Daily family interaction (reading, singing, stories, meals) occurred in approximately half of families
Limitations
This is a secondary analysis of cross-sectional survey data, so causation cannot be established and the direction of relationships is unclear. The study relies on parental reports and does not account for unmeasured confounders or the specific mechanisms through which family routines protect sleep.
Abstract
Background/objectives Sleep health is a multi-faceted biopsychosocial concept that affects well-being across the lifespan. Insufficient sleep occurs in large numbers of children and there is emerging evidence for the influence of socioecological factors and adverse childhood experiences (ACEs). The purpose of this study was to determine the influence of adverse childhood experiences on sleep health in preschool age children as mediated by family interaction habits and outdoor play. Methods Our secondary analysis of the 2023 National Survey of Children's Health used the weighted dataset filtered for children ages 3-5 years. Results Sixty-six percent of parents reported adequate child sleep; nearly 89% of parents reported consistent bedtimes. Seventy-one percent reported no ACEs. Most children had one or more hours of outdoor play each day. Daily family interaction (reading, singing, stories, meals) occurred in approximately half of families. Structural equation modeling results indicated that the negative effects of ACEs on consistent bedtime were mediated by reading aloud and family meals, while adequate sleep duration was mediated by reading aloud and singing/storytelling. Conclusions These findings represent a promising picture of young children and families, and insight into a window of time during child development when family interaction can positively affect sleep health in spite of adverse childhood experiences.