The Mediating Role of Sleep Duration in the Association Between Adverse Childhood Experiences and Depressive Symptoms Among Middle-Aged and Older Chinese Adults: A Nationwide Longitudinal Study

ObjectivesExamine longitudinal mediation of sleep duration between adverse childhood experiences (ACEs) and depressive symptoms in middle-aged and older adults.MethodsWe analyzed data from six waves (2011, 2013, 2014, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study (CHARLS) using parallel process Latent Growth Curve modeling.ResultsHigher ACEs were associated with shorter initial sleep (<i>β</i>_iSD = -0.064), and higher initial depressive symptoms (<i>β</i>_iDEP = 0.111). Mediation analysis revealed that shorter initial sleep duration indirectly linked higher ACEs to both a higher initial level of depressive symptoms (<i>β</i> = 0.027) and a faster increase in depressive symptoms over time (<i>β</i> = -0.017). Mediation via initial sleep was stronger for deprivation-related ACEs (28.0%) than threat-related (16.4%).ConclusionsACEs are linked to shorter initial sleep duration and a higher risk of depressive symptoms. Initial sleep partially mediates these associations. Increasing sleep may alleviate depressive symptoms in ACEs-exposed individuals.