P3B208: Adverse Childhood Experiences and Accelerometer-measured Physical Activity and Sleep in Pre-adolescents

Background: Little is known about the relationship between adverse childhood experiences (ACEs) and objective measures of physical activity and sleep in pre-adolescents. One prior study found that ACEs were related to worse sleep and less physical activity, as reported by parents.

Methods: Data from the baseline and one-year follow-up of the adolescent brain and cognitive development (ABCD) study (age 9-10, n = 6226 for physical activity; n=4146 for sleep) were examined to analyze the association between ACEs and objective measures of sleep and physical activity. ACEs were assessed by parent report at baseline with three levels: none, exposure to one ACE, and exposure to two or more ACEs. Objective measures of physical activity and sleep were assessed with an accelerometer at the one-year follow-up. For physical activity, daily steps and minutes of moderate to vigorous physical activity were recorded. For sleep, total minutes of sleep and minutes of rapid eye movement (REM) sleep were assessed. Linear regression analyses were used to examine the relationship between ACEs and measures of physical activity as well as sleep, adjusting for family income and sex assigned at birth.

Results: Approximately 42% of participants were exposed to no ACEs, 32% were exposed to one ACE, and 36% were exposed to two or more ACEs. On univariate analyses with ANOVA, ACEs were associated with less physical activity (p < 0.001 for daily steps; p=0.02 for minutes of moderate or vigorous exercise). ACEs were also associated with less sleep (p < 0.001 for sleep duration; p< 0.001 for REM sleep duration). On multivariate analyses adjusting for family income and sex assigned at birth, compared to children with no ACEs, children with ACEs had fewer daily steps: one ACE (β=-311 (95% CI -496 to -125), p=0.001) and two or more ACEs (β= -380 (586 to -173), p< 0.001) (Figure 1). Children exposed to ACEs had fewer minutes of moderate or vigorous physical activity per day: one ACE (β=-1.8 (95% CI -3.5 to -0.1), p=0.04) and two or more ACEs (β=-2.0 (95% CI -3.9 to -0.1), p=0.04). ACEs were also associated with shorter sleep duration (minutes), although only for participants with two or more ACEs (one ACE (β= -2.6 (-5.7 to 0.6), p=0.11 and two or more ACEs (β=-5.4 (-8.8 to -1.9), p=0.002) (Figure 2). REM sleep was reduced in participants with ACEs (one ACE (β=-1.5 (-2.8 to -0.1), p=0.03) and two or more ACEs (β=-2.3 (-3.8 to -0.8), p=0.003).

Conclusion: There is a dose-response relationship between ACEs and reduced daily steps, minutes of moderate to vigorous physical activity, total sleep duration, and REM sleep in pre-adolescents. These differences may contribute to the association of childhood adversity with medical and psychiatric illness later in life.