Reduced Sleep Efficiency Mediates the Association of Adverse Childhood Experience Exposure with Impaired Vascular Endothelial Function in Young Adults

• Published in: Physiology (Bethesda, Md.) Md.), 2023-05, Vol.38 (S1)
• Main Authors: Schwager, Laura, Diesel, Sara, Flores, Mark, Schneider, Alyssa, Harris, Jordan, Pierce, Gary, Liu, Junjie, Fonkoue, Ida, Thomas, Emily, Jenkins, Nathaniel
• Format: Article
• Language: English
• ISSN: 1548-9213; 1548-9221
• DOI: 10.1152/physiol.2023.38.S1.5728456

Abstract only Introduction: Adverse childhood experiences (ACEs) are severe psychosocial stressors during the first 18 years of life that promote substantial increases in lifetime risk of cardiovascular disease. ACEs are highly prevalent and associated with impaired vascular endothelial function (VEF) and poor sleep, established cardiovascular risk factors. The purpose of this study was to investigate the role of sleep efficiency (SE%) in the association of ACEs with impaired VEF in young adults. We hypothesized that SE% would mediate the association of ACEs with impaired VEF. μethods: In 22 young adults (75% Female; age = 26 ± 7 y), we assessed ACE exposure and anxiety and depressive symptoms using the Zung Self-Rating Anxiety and Center for Epidemiologic Studies Depression scales, respectively. We assessed SE% as the reported total sleep duration relative to the time-in-bed from the Pittsburgh Sleep Quality Index. We also measured VEF using the flow mediated dilation technique normalized to the shear rate area under the curve. Using zero-order correlations we examined relations among ACE exposure, anxiety and depression symptoms, SE%, VEF, and age. We then utilized multiple-linear regression to examine the effect of ACE exposure and SE% on VEF while accounting for anxiety and depression symptoms. Finally, to better understand the role of SE% in the association of ACE exposure with VEF, we conducted mediation analysis with SE% as the mediator using the bootstrapped bias-corrected percentile confidence interval method. Results: ACEs were highly prevalent (64% with ≥1 ACE; 32% with ≥3 ACEs) and variable (range = 0 – 8 ACEs) in our sample. ACE exposure was associated with anxiety (r=0.48, p=0.018) and depression symptoms (r=0.48, p=0.024), SE% (r=-0.46, p=0.03), and VEF (r=-0.63, p=0.002), but was not associated with age (p=0.96). SE% was associated with VEF (r=0.59, p=0.004), but not correlated with age, anxiety, or depressive symptoms (all p≥0.14). Multiple linear regression analyses indicated that ACE exposure (β=-0.54, p