Background
Methods
Data selection
Frequent insufficient sleep
Adverse childhood experiences
Potential mediators
Covariates
Statistical analyses
Results
Study population characteristics
Characteristic | Unweighted sample size | Weighted % (95% CI) |
---|---|---|
Total
| 25,810 | 100.0 |
Gender
| ||
Men | 9,336 | 48.4 (47.3-49.6) |
Women | 16,474 | 51.6 (50.4-52.7) |
Age, years
| ||
18-24 | 750 | 8.1 ( 7.3- 8.9) |
25-34 | 2,073 | 17.2 (16.2-18.2) |
35-44 | 3,354 | 23.3 (22.1-24.4) |
45-54 | 5,300 | 19.5 (18.7-20.3) |
55-64 | 6,062 | 15.1 (14.6-15.7) |
≥65 | 8,140 | 16.8 (16.2-17.4) |
Race/ethnicity
| ||
White, Non-Hispanic | 19,485 | 77.1 (76.2-78.0) |
Black, Non-Hispanic | 2,599 | 10.7 (10.0-11.5) |
Hispanic | 2,179 | 6.7 ( 6.3- 7.2) |
Non-Hispanic/Others* | 1,356 | 5.4 ( 4.9- 5.9) |
Education attainment
| ||
<High school | 2,540 | 9.0 ( 8.3- 9.7) |
High school graduates or GED | 7,236 | 28.1 (27.0-29.1) |
Some college | 7,465 | 30.1 (29.0-31.1) |
College graduates | 8,541 | 32.8 (31.9-33.8) |
Body Mass Index, kg/m
2
| ||
Underweight (<18.5) | 407 | 1.6 ( 1.3- 1.9) |
Normal Weight (18.5-24.9) | 8,110 | 32.1 (31.0-33.1) |
Overweight (25.0-29.9) | 8,800 | 35.4 (34.3-36.6) |
Obese (≥30) | 7,541 | 30.9 (29.8-32.0) |
Smoking status
| ||
Current smokers | 4,336 | 18.8 (17.8-19.7) |
Former smokers | 7,748 | 26.2 (25.2-27.2) |
Never smoked | 13,639 | 55.0 (53.9-56.1) |
Frequent mental distress (≥14 days/the past 30 days)
| 2,752 | 10.8 (10.1-11.6) |
ACEs before age 18
| ||
Verbal abuse | 6,297 | 26.1 (25.1-27.0) |
Physical abuse | 3,616 | 14.8 (14.0-15.6) |
Sexual abuse | 3,310 | 12.1 (11.4-12.7) |
Substance abusing household member | 7,021 | 29.1 (28.1-30.2) |
Household mental illness | 4,423 | 19.5 (18.6-20.4) |
Witnessing domestic violence | 3,906 | 16.3 (15.5-17.2) |
Incarcerated household member | 1,261 | 7.2 ( 6.4- 7.9) |
Parental separation/divorce | 5,583 | 26.6 (25.6-27.7) |
ACE score
| ||
0 | 11,208 | 40.5 (39.4-41.6) |
1 | 5,894 | 22.4 (21.5-23.4) |
2 | 3,221 | 13.1 (12.3-13.9) |
3 | 2,179 | 8.8 ( 8.2- 9.4) |
4 | 1,435 | 6.5 ( 5.9- 7.2) |
≥5 | 1,873 | 8.7 ( 8.0- 9.3) |
Frequent insufficient sleep (≥14 days/the past 30 days)
| 6,522 | 28.8 (27.7-29.8) |
Frequent insufficient sleep
Characteristic | % (95% CI) |
---|---|
Total
| 28.8 (27.7-29.8) |
Sex
| |
Men | 26.8 (25.1-28.6) |
Women | 30.6 (29.4-31.8) |
Age, years
| |
18-24 | 32.3 (27.6-36.9) |
25-34 | 35.4 (32.2-38.6) |
35-44 | 33.6 (30.8-36.3) |
45-54 | 30.3 (28.3-32.2) |
55-64 | 25.3 (23.5-27.0) |
≥65 | 15.4 (14.2-16.5) |
Race/ethnicity
| |
White, Non-Hispanic | 28.4 (27.2-29.6) |
Black, Non-Hispanic | 31.5 (27.9-35.0) |
Hispanic | 26.4 (23.4-29.5) |
Others | 32.6 (28.2-37.1) |
Educational attainment
| |
<high school | 35.4 (31.4-39.4) |
High school graduates or GED | 27.7 (25.7-29.7) |
Associate degree | 31.9 (29.8-34.0) |
College graduates | 25.1 (23.5-26.7) |
Body Mass Index, kg/m
2
| |
Underweight (<18.5) | 33.5 (25.1-41.8) |
Normal Weight (18.5-24.9) | 26.6 (24.7-28.5) |
Overweight (25.0-25.9) | 27.0 (25.2-28.8) |
Obese (≥30) | 33.2 (31.2-35.2) |
Heavy drinking
| |
No | 28.6 (27.5-29.7) |
Yes | 31.7 (27.2-36.3) |
Smoking status
| |
Current smokers | 40.3 (37.3-43.2) |
Former smokers | 27.3 (25.4-29.3) |
Never smoked | 25.5 (24.2-26.9) |
Frequent mental distress (≥14 days/the past 30 days)
| |
No | 24.5 (23.5-25.6) |
Yes | 63.2 (59.6-66.8) |
Relationships between potential mediators and frequent insufficient sleep
Relationships between adverse childhood experiences and potential mediators
Adverse childhood experience | Current smoking % (95% CI) | Frequent mental distress % (95% CI) |
---|---|---|
Verbal abuse
| ||
No | 16.1 (15.0-17.2) | 8.2 ( 7.4- 9.0) |
Yes | 26.4 (24.4-28.4) | 18.2 (16.5-20.0) |
Physical abuse
| ||
No | 17.1 (16.1-18.1) | 9.1 ( 8.3- 9.9) |
Yes | 28.5 (25.8-31.2) | 21.1 (18.7-23.4) |
Sexual abuse
| ||
No | 17.6 (16.6-18.6) | 9.4 ( 8.6-10.2) |
Yes | 27.4 (24.5-30.3) | 21.2 (18.8-23.6) |
Substance abusing household member
| ||
No | 15.5 (14.5-16.6) | 8.3 ( 7.5- 9.1) |
Yes | 26.7 (24.6-28.8) | 17.0 (15.3-18.7) |
Mentally ill household member
| ||
No | 17.4 (16.3-18.4) | 8.8 ( 8.0- 9.6) |
Yes | 24.6 (22.4-26.9) | 19.3 (17.3-21.3) |
Witnessing domestic violence
| ||
No | 17.1 (16.1-18.0) | 9.2 ( 8.4- 9.9) |
Yes | 27.7 (24.7-30.6) | 19.4 (16.9-21.9) |
Incarcerated household member
| ||
No | 17.3 (16.4-18.3) | 9.9 ( 9.2-10.6) |
Yes | 37.5 (32.0-43.0) | 22.9 (18.4-27.4) |
Parental separation/ divorce
| ||
No | 15.8 (14.8-16.7) | 9.6 ( 8.8-10.4) |
Yes | 27.1 (24.7-29.5) | 14.2 (12.3-16.1) |
ACE score
| ||
0 | 13.0 (11.7-14.2) | 6.0 ( 5.1- 6.9) |
1 | 17.9 (15.9-19.9) | 8.9 ( 7.2-10.5) |
2 | 19.5 (16.6-22.4) | 11.1 ( 9.3-12.9) |
3 | 21.4 (18.2-24.6) | 16.8 (13.5-20.0) |
4 | 27.8 (23.0-32.5) | 17.2 (13.8-20.6) |
≥5 | 37.8 (33.7-41.9) | 27.3 (23.6-30.9) |
Relationships between adverse childhood experiences and frequent insufficient sleep
ACE | % (95% CI) | Model 1 AOR (95% CI) | Model 2 AOR (95% CI) | Model 3 AOR (95% CI) |
---|---|---|---|---|
Verbal abuse
| ||||
No | 25.6 (24.4-26.8) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 37.9 (35.8-40.0) | 1.59 (1.42-1.79) | 1.50 (1.33-1.68)* | 1.32 (1.16-1.50)† |
Physical abuse
| ||||
No | 26.7 (25.6-27.8) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 40.9 (38.0-43.8) | 1.71 (1.50-1.97) | 1.62 (1.41-1.86)* | 1.43 (1.23-1.65)** |
Sexual abuse
| ||||
No | 27.1 (26.0-28.3) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 40.9 (37.9-43.8) | 1.66 (1.44-1.93) | 1.56 (1.35-1.81)* | 1.40 (1.19-1.64)** |
Substance abusing household member
| ||||
No | 25.7 (24.5-26.8) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 36.4 (34.3-38.6) | 1.47 (1.30-1.65) | 1.38 (1.23-1.55)* | 1.25 (1.10-1.42)† |
Mentally ill Household member
| ||||
No | 26.0 (24.8-27.1) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 40.4 (37.9-43.0) | 1.68 (1.47-1.92) | 1.60 (1.40-1.83)* | 1.42 (1.23-1.64)** |
Witnessing domestic violence
| ||||
No | 26.8 (25.7-27.9) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 39.1 (36.2-42.0) | 1.58 (1.37-1.82) | 1.51 (1.31-1.73)* | 1.35 (1.16-1.57)** |
Incarcerated household member
| ||||
No | 27.8 (26.7-28.8) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 42.1 (36.7-47.5) | 1.54 (1.21-1.95) | 1.40 (1.10-1.78)** | 1.23 (0.95-1.60)† |
Parental separation/ divorce
| ||||
No | 26.5 (25.4-27.7) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
Yes | 35.0 (32.6-37.3) | 1.23 (1.08-1.40) | 1.16 (1.02-1.32)** | 1.14 (0.99-1.31)** |
ACE score
| ||||
0 | 21.3 (19.8-22.8) | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
1 | 27.0 (24.9-29.1) | 1.28 (1.11-1.49) | 1.25 (1.08-1.45)* | 1.21 (1.04-1.41)** |
2 | 34.7 (31.6-37.8) | 1.74 (1.46-2.06) | 1.68 (1.41-1.99) | 1.61 (1.35-1.92)* |
3 | 34.4 (31.0-37.8) | 1.68 (1.40-2.02) | 1.60 (1.33-1.93)* | 1.41 (1.15-1.72)** |
4 | 38.1 (33.0-43.2) | 1.91 (1.48-2.46) | 1.77 (1.39-2.26)* | 1.56 (1.20-2.03)** |
≥5 | 47.0 (42.9-51.0) | 2.53 (2.09-3.06) | 2.26 (1.86-2.75)* | 1.80 (1.46-2.21)† |