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Introduction Adverse childhood experiences can increase likelihood of hyperarousal, especially around periods of vulnerability. Survivors of trauma also experience more nightmares. These data explore whether adverse childhood events are associated with adult insomnia severity and nightmares. Methods Data were obtained from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults 22-60 years recruited from southeastern Pennsylvania. Adverse childhood experiences were defined as a self-reported history of child abuse, parent divorce, parent death, parent with depression, parent with anxiety disorder, and childhood poverty (yes/no). Insomnia severity was assessed using the Insomnia severity Index (ISI), evaluated both as a continuous variable and categorical: None (0-7) vs Mild (8-14) or Moderate-Severe (15+). Nightmares were assessed ordinally using the following anchors: Never, Seldom, Sometimes, Often, or Frequently. Covariates included age, sex, race/ethnicity, and education. Additional models included depression severity, assessed using a modified version of the Patient Health Questionnaire-9. Results Child abuse was associated with an additional 2.9 points on the ISI, and parental divorce, death, depression, and anxiety were associated with an additional 1.2, 1.7, 1.8, and 1.8 points, respectively (all p< 0.005). After adjustment for depressed mood, relationships remained for child abuse, parent divorce, and parent death. In evaluating categorical insomnia, child abuse was associated with both mild (RRR=2.64, p< 0.0005) and moderate-severe (RRR=3.37, p< 0.0005) insomnia. Parent death was associated with an increased likelihood of moderate-severe insomnia (RRR=1.94, p=0.007). Parent divorce, depression, and anxiety were all associated with increased mild (RRR=1.44 [p=0.03], RRR=1.85 [p=0.001], and RRR=1.85 [p=0.004], respectively) and moderate-severe (RRR=1.50 [p=0.03], RRR=2.24 [p< 0.0005], and RRR=2.40 [p< 0.0005], respectively) insomnia. More frequent adult nightmares were reported by those who reported a history of child abuse (oOR=1.9, p< 0.0005), parent death (oOR=1.6, p=0.007), parent depression (oOR=1.6, p< 0.0005), and parent anxiety (oOR=1.8, p< 0.0005). After adjustment for depression, relationships with child abuse and parent death were maintained. Child poverty was not associated with insomnia or nightmares. Conclusion Adverse childhood events may contribute to later risk for insomnia and nightmares. Further efforts are needed to establish causality and develop interventions, which may have residual effects on mental and physical health. Support (if any)

Introduction Effects of child temperament on biopsychosocial outcomes, including sleep, are known to differ based on parent-child relationship quality (PCRQ). However, previous studies have primarily focused solely on early childhood, relied on subjective reports of PCRQ and sleep, and have neglected to examine variability in sleep, which is an important dimension of sleep health. We examined whether there were interactions between temperament and objectively measured PCRQ during early childhood in association with actigraphy measured sleep (average and variability) in middle childhood. Methods Participants included 90 preschoolers (mean age=4.24 years, SD=0.81) who were 47% female; 37% White, 17% Black, 47% other racial groups; and 46% Hispanic. Thirty-four percent experienced moderate to severe maltreatment. PCRQ was coded from a video-recorded free-play task between each child and their primary caregiver. Child temperament dimensions including Activity Level, Anger, Social Fear, Inhibitory Control, and Appropriate Attentional Allocation were measured with the parent-report Toddler Behavior Assessment Questionnaire. Child Mean and SDs of total sleep time (TST) and sleep efficiency (SE) were generated from actigraphy data collected for two weeks during a follow-up study when participants were ages 8-11. Results There were no direct effects of any of the temperament variables or PCRQ on sleep. In models adjusted for demographic characteristics and number of adversities experienced, greater attentional allocation was associated with greater average TST only among those children high in PCRQ (estimate = 20.59, 95% CI = 5.19, 35.99). For every one unit increase in attentional allocation score (possible range 1:7), there is a more than 20 min increase in mean TST. In contrast, greater activity levels were associated with better average sleep efficiency, only among those low in PCRQ (estimate = 2.35, 95% CI = 0.46, 4.24). For each unit increase in activity level score, there was a 2% increase in sleep efficiency. Conclusion Findings extend cross-sectional research in early childhood and provide support for models showing that children have differing susceptibility to the effects of temperament on sleep, depending on PCRQ. Support (if any) NIMH R01 MH083704, NICHD R01 HD086487, NICHD, R01 HD095837, SRCD Small Grant for Early Career Scholars, T32HD101392, NIGMS P20 GM139767.

Introduction Adverse childhood events have been linked with many mental and physical health risks, but less work has explored nighttime and daytime sleep problems, especially inability to control sleep. Methods Data were obtained from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults aged 22-60 years recruited from communities in southeastern Pennsylvania. Adverse childhood experiences were defined as a self-reported history of child abuse, parent divorce, parent death, parent with depression, parent with anxiety disorder, and childhood poverty (yes/no). Habitual sleep duration was assessed in hours, daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS), and control over sleep was assessed with the Brief Index of Sleep Control (BRISC). Covariates included age, sex, race/ethnicity, and education. Additional models included depression severity, assessed using a modified version of the Patient Health Questionnaire-9. Results History of child abuse was associated with 23 fewer minutes of nighttime sleep (p=0.001), and parent anxiety was associated with 15 fewer minutes (p=0.048). When depression was added to the model, the effects for sleep duration were attenuated (15.3 minutes, p=0.03). No other relationships were observed. Regarding control over nighttime sleep, decreased sense of control was reported by those who experienced child abuse (B=-0.4, p< 0.0005), parent divorce (B=-0.1, p=0.035), and parent depression (B=-0.2, p=0.02). After adjusting for depression, the relationship with child abuse was attenuated but maintained (B=-0.2, p< 0.0005). Elevated ESS scores were seen in those who reported child abuse (B=4.7, p< 0.0005), parent depression (B=4.3, p< 0.0005), and parent anxiety (B=3.9, p< 0.0005). After adjusting for depression, relationships were attenuated but maintained for child abuse (B=2.0, p=0.02), parent depression (B=2.2, p=0.004), and parent anxiety (B=2.2, p=0.017). Conclusion Adverse childhood events may lead to sleep/wake dysregulation, including less sleep at night, more sleepiness during the day, and decreased sense of control over sleep ability. Future efforts might focus on increasing control over nighttime sleep and reducing daytime sleepiness. Support (if any)

Introduction Sleep patterns may partially account for associations between early life adversity and poor health outcomes; however, few studies have empirically tested this hypothesis. We examined whether an index of sleep regularity mediated associations between child maltreatment (CM) and depression symptoms among emerging adults undergoing the major life transition of starting college. Methods First-year college students (N=731; 41% male; 48% Non-Hispanic White, 21% Non-Hispanic Asian, 15% Hispanic all races, 5% Non-Hispanic Black, and 11% Non-Hispanic other races) completed daily sleep diaries (DSDs) for 9 weeks and completed the Childhood Trauma Questionnaire (CTQ) and Center for Epidemiologic Studies Depression Scale (CES-D) following DSD completion. DSD data were used to compute participants’ Sleep Regularity Index (SRI). We used a nonparametric SEM bootstrap approach to examine whether sleep regularity mediated associations between childhood trauma and depressive symptoms, controlling for sex, race/ethnicity, and US vs. international status. Separate models were run for CTQ total score and five CTQ subscale scores: emotional, physical, and sexual abuse, and physical and emotional neglect. Results The prevalence of moderate to severe CM was 20.7%, and 40% reported clinically significant depressive symptoms at the end of the assessment period. Significant indirect effects of CTQ total score (estimate=0.02, 95% CI=0.003, 0.036); emotional abuse (0.06 [0.004, 0.107]); physical abuse (0.08 [0.003, 0.164]); sexual abuse (0.06 [0.014, 0.114]); emotional neglect (0.04 [0.002, 0.075]) on greater depression symptoms through lower sleep regularity were observed; and we saw no significant indirect effect of physical neglect (0.04 [-0.015, 0.089]). The percentage of the total effect of CM (i.e., CTQ total score and subscale scores) on greater depressive symptoms accounted for by lower sleep regularity were CTQ total score: 6%; physical abuse: 24%; sexual abuse: 19%; emotional abuse: 7%; and emotional neglect: 5%. Conclusion Variable sleep patterns account, in part, for associations between CM and depressive symptoms among first-year college students, with the largest effects observed for physical and sexual abuse. Sleep regularity should be included as a target in student health interventions on college campuses and may help buffer against poor mental health outcomes for students with CM. Support (if any) P20GM139743, MH079179, T32HD101392, P20GM139767.

Introduction ERS telecommunicators are the first of the first responders challenged with solving complex, time-sensitive problems while managing workplace presence. Very little is known about sleep, work, and lifestyle factors among workers in this industry. One study demonstrated that 85% of ERS telecommunicators are overweight, suggesting that job-related factors may place these workers at risk for sedentary lifestyles. To test this hypothesis, we examined whether 14 day total work duration moderated the daily relationship between prior-night total sleep time and next day energy expenditure. Methods Over the course of 14 days (M = 6.9 days on-shift; SD = 1.9 days), 47 ERS telecommunicators were instructed to (a) wear actigraphs on their waist to gather estimates of average energy expenditure (EE, kcal/hour), (b) wear actigraphs on their wrist to gather estimates of total sleep time (min), and (c) complete daily shift logs to gather information about work duration (hours). Mixed linear modeling was employed to examine whether prior night within-subject total sleep time (TST) predicted next day energy expenditure, as moderated by between-subject work hours (n = 525 cases). Results A significant cross-level Work Duration x TST interaction (Estimate = .007, SE = .002, p < .001, 95% CI [.003, .011]) indicated that less prior-night TST was associated with less next-day EE among telecommunicators who worked more hours over the last 14 days. Conversely, telecommunicators who worked fewer hours expended more energy per hour the next day when they slept less than usual. Simple effects indicated that for each extra 102 minutes sleep (+1 SD), telecommunicators expended 5 kcal/hr (90 kcal over 18 hours awake). These results remained stable when controlling for between-subject differences in sleep and within-subject changes in work duration, night-shift work, and other relevant covariates. Conclusion The effect of total sleep time on next-day EE is unique to each telecommunicator’s typical sleep levels and the total hours worked over the course of two weeks. These two risk factors operate on EE as a function of one another. Findings provide support for the implementation of policy-level intervention to minimize chronic overwork and individual-level intervention to support sleep prioritization. Support (If Any) UA Canyon Ranch Center for Health Promotion and Treatment

Introduction Despite the growing body of evidence linking child maltreatment to compromised sleep health in adulthood, links in emerging adults are understudied. We examined associations between child maltreatment (CM) and multidimensional sleep health among emerging adults undergoing the major life transition of starting college. Methods First-year college students (N=682, 41% male, 48% Non-Hispanic White, 22% Non-Hispanic Asian, 15% Hispanic all races, 6% Non-Hispanic Black, and 9% Non-Hispanic other races) completed daily sleep diaries (DSDs) for 9 weeks, and completed the Childhood Trauma Questionnaire (CTQ), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI) following DSD completion. We used linear regression models to examine associations between CTQ-derived CM (0=none, 1=any [moderate to severe emotional abuse/neglect, physical abuse/neglect, or sexual abuse]) and sleep health (Buysse, 2014) using a multidimensional score encompassing components from the RUSATED model (regularity [DSD sleep midpoint SD: 0= >1 hour, 1= ≤1 hour], satisfaction [PSQI sleep quality item: 0=fairly or very bad, 1=very or fairly good], alertness [ESS score: 0= >10, 1= ≤10], timing [DSD sleep midpoint: 0= 5:30, 1= ≥3:30 and ≤5:30], efficiency [DSD sleep efficiency: 0= 10 hours, 1= ≥7 hours and ≤10 hours]. Results In the full sample 20.5% reported CM (within-group prevalences: females 21%, males 20%, Non-Hispanic Whites 12%, Non-Hispanic Asians 28%, Hispanics of all races 26%, Non-Hispanic Blacks 34%, and Non-Hispanics of other races 30%). Those with CM had significantly worse sleep health (B=-0.25, 95% CI=-0.46, -0.04) compared to those without CM, but not after adjustment for sex and race/ethnicity. In logistic regression models, the only individual sleep health component significantly associated with CM was sleep satisfaction. After adjustment for sex, race/ethnicity, and depressive symptoms, those who experienced CM had a 52% lower odds of reporting good sleep quality (OR=0.48, 95% CI=0.30, 0.76). Conclusion CM is associated with worse sleep satisfaction among first-year college students, which aligns with previous research in older adults. Additional research should examine neurophysiological correlates of sleep satisfaction in the context of child maltreatment and effects on subsequent health. Support (If Any) P206M139743, MH079179, T32HD101392.