Abstract P2148: Adverse Childhood Experiences are Associated with Poor Sleep Among Racial and Ethnic Minoritized Patients with Recent Myocardial Infarction

Abstract

Introduction: Disparities in sleep are well documented and may increase the risk of poor cardiovascular disease (CVD) outcomes in racial and ethnic minoritized groups. These groups are also more likely to report adverse childhood experiences (ACEs), which can impact sleep. The relationship between ACEs and sleep quality in adults with CVD, including those recovering from myocardial infarction (MI), is underexplored. Objective: To examine the association between ACEs and sleep quality in patients with recent MI. Methods: We analyzed baseline data from an ongoing longitudinal study of adults post-MI. Exposure to five ACEs was assessed (each yes/no): living with someone with chronic illness/disability, mental illness or substance abuse; parental separation/divorce; long-term financial problems. Sleep quality over the past 7 days was assessed with a single item rated 0–10, dichotomized as poor (0–3) vs. fair/good/excellent (4–10). Participants completed validated measures of anxiety, depressive symptoms and perceived stress. We used chi-square tests and linear regression to test associations between ACEs exposure and sleep quality. Results: The 161 participants (36.9% women, 34.4% from racial and ethnic minoritized groups, age 62±13 years) completed questionnaires at median 37.5 days post-MI (IQR=21–61). About half of participants (50.9%) reported ≥1 ACE and 21.7% reported poor sleep; these were somewhat more common among participants from minoritized groups vs. non-Hispanic White adults (≥1 ACE, 60.0% vs. 46.7%, p=0.08; poor sleep, 30.9% vs. 17.1%, p=0.04). Participants from minoritized groups with ≥1 ACE were more likely than those with no ACEs to report poor sleep (45.4% vs. 9.1%, p=0.006). This association was significant after adjusting for sociodemographic (age, sex, race/ethnicity, low income, marital status) and clinical (time since MI, diabetes, hypertension, body mass index) factors (B=-1.683, p=0.03), and was no longer significant when psychological factors (anxiety, depressive symptoms, perceived stress) were added (B=-1.344, p=0.10). There was no difference in poor sleep between non-Hispanic White participants who did vs. did not report ACEs in univariate (18.4% vs. 16.1%, p=0.80) or multivariate analyses (B=-0.054, p=0.91). Conclusions: ACEs exposure was associated with poorer self-reported sleep quality in MI patients from racial and ethnic minoritized groups. This association was mediated in part by effects of ACEs on psychological distress.