Trauma Worsens Poor Sleeps Impact on Kids Heart Health

Research highlights:

• Children ages 6 to 17 who had more traumatic experiences, as reported by their parents, were more likely to also have too little or too much sleep. Previous research has shown that adverse childhood experiences and insufficient sleep are both associated with negative cardiovascular outcomes later in life.
• The retrospective analysis of data from more than 100,000 children in the US collected between 2018 and 2021 found that more than a third of children were not getting the amount of sleep recommended by the American Heart Association’s Life’s Essential. hours per night for children 6 to 12 years old, and 8 to 10 hours per night for children 13 to 18 years old.

Embargoed until 4:00 AM CT/5:00 AM ET, Monday, November 6, 2023

DALLAS, November 6, 2023 – Traumatic events experienced during childhood may increase the negative health effects of too much or too little sleep on children’s cardiovascular health, according to preliminary research to be presented at the American’s Scientific Sessions 2023 Heart Association. held in Philadelphia from November 11 to 13, is a premier global exchange of the latest scientific advances, research and evidence-based clinical practice updates in cardiovascular science.

The analysis of more than 100,000 children in the US found that more than a third of them were not getting the amount of daily sleep recommended by the American Heart Association’s Life’s Essential 8, which is 10 to 16 hours of sleep per 24 hours, including naps for children aged 5 and under; 9-12 hours per day for children aged 6-12; and 8-10 hours for children aged 13-18. According to Life’s Essential 8, insufficient or excessive sleep is a major risk factor for suboptimal cardiovascular health. This study is one of the first to examine the prevalence of insufficient or excessive sleep duration among youth using Life’s Essential 8 health assessment tool.

Previous research has also shown that adverse childhood experiences are associated with an increased risk of cardiovascular disease, type 2 diabetes and/or stroke later in life. Adverse childhood experiences are potentially traumatic events that can affect health and well-being. In this study, traumatic events included parental divorce; the death or imprisonment of a parent; experiencing violence; living with a person with alcohol or drug addiction or mental health problems; physical, emotional or sexual abuse; or unfair treatment because of their race, ethnicity, sexual orientation and/or gender identity.

Researchers examined data from the 2018-2019 and 2020-2021 National Survey of Children’s Health to examine the association between sleep duration and the number of reported adverse childhood experiences among U.S. children. The surveys included demographic questions about the children and detailed questions about their health and behavior, as well as their household. Parents or guardians responded yes or no to the question of whether their child had ever experienced any of the traumatic events on the list, whether the household had had financial difficulties since the child’s birth and how many hours their child slept most weeknights.

“Understanding sleep quality in children and adolescents can provide valuable insight into the link between adverse childhood experiences and sleep,” said lead study author MinKyoung Song, Ph.D., RN, FNP, FAHA, University associate professor at Oregon Health & Sciences University School of Nursing. “Children who get too little or too much sleep are likely not to get the right amount of sleep into adulthood, and early intervention may be necessary to combat the progressive negative effects that suboptimal sleep can have on cardiovascular and other metabolic processes.”

The analysis showed:

• More than a third of the 101,105 children did not meet recommended sleep standards – either by not getting enough sleep or by sleeping too much.
• Children with more reported adverse childhood experiences were more likely to have too much or too little sleep.
• Each additional traumatic event increased by 8% the chance that a child would sleep 1-2 hours less or 1+ hours more than recommended; or increased by 26% the likelihood that a child would sleep more than 2 hours less than recommended.

“These findings suggest that traumatic events during childhood may amplify the adverse effects of insufficient or excessive sleep on heart health,” Song said. She emphasized that these results underscore the importance of healthcare professionals understanding and integrating trauma-informed care into their clinical practice, as well as for future research on the development of resilience, emotional support and positive relationships, especially for children who have experienced traumatic events .

“Similarly, parents and caregivers should be aware that insufficient sleep is linked to negative cardiovascular health outcomes,” she added.

Study background and details:

• A total of 101,105 children in the US, ages 6 to 17, participated in the study.
• The parents or guardians of 42,141 children answered survey questions about their children for the 2018-2019 National Survey of Children’s Health. 58.22% of children were 6-12 years old and 41.78% were 13-17 years old. 50.89% identified as male and 49.11% were female. The races and ethnicities of the children parents reported included: 50.3% were white, non-Hispanic; 25.71% selected Hispanic, 13.55% identified as Black, non-Hispanic; and 10.44% selected multiracial or other, non-Hispanic.
• The parents or guardians of 58,964 children answered survey questions about their children for the 2020-2021 National Survey of Children’s Health. 51.04% of children identified as male and 48.96% were female. The races and ethnicities of the children that parents reported included: 50.21% chose white, non-Hispanic; 26.05% identified as Hispanic; 13.34% selected black, non-Hispanic; and 10.4% identified as multiracial or other, non-Hispanic.
• In this study, children were divided into three subgroups: 1) children who met age-appropriate or optimal sleep duration; 2) those who reported about 1-2 fewer or 1+ hours more sleep than recommended each night; and 3) those who reported two or more hours less than recommended each night. Both groups 2 and 3 were considered to have suboptimal sleep duration.
• In the NSCH surveys, the question about household financial problems had four response options – never, rarely, somewhat often or very often – but for this analysis these were combined into two categories: somewhat often/very often or never/rarely unfavorable.

The study had several limitations. It relied on survey questionnaires completed by parents or guardians, the results of which may not be as accurate due to recall bias – errors that occur when participants fail to remember or misremember previous events – and possible under- or over-reporting of information since being their opinions and perspective on the child versus the child’s own perspective. Furthermore, because the data contain information from only one time point, these findings cannot confirm a causal relationship between adverse childhood experiences and sleep duration.

“The research found that traumatic events exacerbate the effects of poor sleep on children’s health, and I am not surprised by these findings. Much of what we experience every day affects the quality and duration of our sleep,” says Carissa Baker. Smith, MD, MPH, MS, FAHA, director of pediatric preventive cardiology at Nemours Children’s Hospital in Wilmington, Delaware, and co-author of the Association’s 2023 Scientific Statement on Pediatric Primary Hypertension. “Parents need to understand that our mental health plays an extremely important role in the way we sleep and the quality and duration of our sleep. When children experience changes in mental health, such as depression or anxiety, these are important things to discuss, address and work toward resolution.”

Co-authors, disclosures, and funding sources are listed in the abstract.

Statements and conclusions of studies presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the association. The Association makes no representation or warranty as to its accuracy or reliability. Abstracts presented at the association’s scientific meetings are not peer-reviewed, but are compiled by independent review panels and are judged on the basis of their potential to contribute to the diversity of scientific issues and views discussed at the meeting . The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.