DOHaD 2022: Early Adverse Childhood Experiences and Sleep

Research Summary: DOHaD 2022: Early Adverse Childhood Experiences and Sleep

Conference Summary

The Developmental Origins of Health and Disease (DOHaD) World Congress is an international conference that takes place every 2-3 years. This year’s meeting took place August 29 – 31 and was held in Vancouver, British Columbia. DOHaD Canada and Kids Brain Health Network (KBHN) were both partners with DOHaD’s International Society for this conference. DOHaD promotes research into fetal and developmental origins of disorders and diseases. Researchers from many fields present their findings at DOHaD conferences, including public health policy, developmental biology, nutrition, genetics, cancer, pregnancy/birth complications, and heart disease.  This year, multiple events highlighted the perspectives and experiences of Indigenous and First Nations People both in Canada and in other countries. The topics of Climate Change and Social Inequities were also discussed in sessions throughout the conference.

DOHaD 2022 Session:

Early Brain Development and the Origins of Infant Mental Health

Presentation:

Social Origins of Developmental Risk for Mental Illness

Presenting Author:

Judy L. Cameron, PhD

Department of Psychiatry

University of Pittsburgh

Background

Early adverse childhood experiences (ACEs) have been shown to lead to long-term impacts on physical health, mental health, interpersonal relationships, and performance at work/school¹. Examples of ACEs include childhood abuse, neglect, loss of a parent, or having caregivers with a history of addiction or mental illness. Children with developmental disabilities are more likely to experience ACEs than their neurotypical peers². People who experienced four or more ACEs in their childhood are more likely to have physical and mental health challenges later in life¹. A common health issue in people with a history of childhood trauma is insomnia, with trouble getting to sleep quickly and an inability to stay asleep both being problematic³. ACEs can affect the ability to sleep soundly through the night well into adulthood, with the more ACEs a person experiences, the less sleep they get⁴. Researchers are looking at the role sleep plays in the long-term health impact of ACEs, and what can be done to protect the physical and mental health of individuals who had a high number of ACEs growing up.

Why does childhood trauma cause poor sleep?

When we are exposed to stressful experiences for a long period of time, our bodies release hormones that “activate” us to be tense and increase our awareness of our surroundings (e.g., hypervigilance). When these stressful experiences happen often and from an early age, these stress hormones can impact brain development^5,6. People with childhood trauma may have differences in the brain structures involved in arousal, memory, and sensory processing, all of which also play a role in sleep^6,7.

DOHaD presentation: How can better sleep help people with Adverse Childhood Experiences (ACEs)?

Dr. Judy L. Cameron studies how ACEs impact early brain development. Her research focuses on both human and animal studies and has explored how the timing of stressful experiences and the type(s) of trauma experienced can interfere with the development of key brain regions. These then lead to long-term changes in mental and physical health. For example, if a childhood trauma happens while the hypothalamus is developing, a person may have trouble with sleep because their circadian rhythm (internal body clock) is controlled by a part of the hypothalamus⁸. Changes in the amygdala can impact both social-emotional skills and fear processing⁶. Dr. Cameron’s research also examines whether certain interventions can protect individuals from lifelong consequences to their health and mental health. The idea is to see whether promoting ‘protective factors’, including healthy sleep habits, will help prevent long-term damage to health and wellbeing. This approach is being tested via a community-based educational program called Working for Kids: Building Skills^TM , with a goal of teaching social-emotional and problem-solving skills that will set children up for success. Due to its important role in social-emotional regulation, guidance for developing sleep habits will be included in additional modules of this program. This research is ongoing and not ready for publication yet.

How do you know if you have sleep difficulties?

People can struggle with sleep either by a) having trouble falling asleep, b) waking up in the middle of the night, and/or c) not feeling rested after sleeping. In some cases, physical issues like obstructive sleep apnea are causing poor sleep. Be sure to tell your doctor if you regularly get poor sleep and feel tired even after you have rested.

What can I do with this information?

Remember, people with ACEs can improve their sleep and emotional-regulation skills. If you believe you or someone you love may have sleep issues related to traumatic experiences from childhood, you can try the following:

Create a regular sleep schedule: Try to go to bed and wake up around the same time each day, even on weekends

Promote relaxation: Try to do some gentle stretching, breathing exercises, mindfulness mediation, or other self-care and calming activities before bed

Physical activity: Regularly exercise at least one hour before bedtime to help promote better sleep

Seek professional help: Working through trauma with a trained mental health professional can lead to fewer night terrors/flashbacks interrupting sleep

Check out AIDE Canada’s helpful animation on developing better sleep habits. The script was written by Dr. Penny Corkum, one of Canada’s leading researchers on sleep difficulties in children: Developing Health Sleep Habits: Animated Video

For parents with children who struggle with sleep, read AIDE Canada’s toolkit with helpful tips from experts: Sleep Challenges in Developmental Disabilities

If you are a parent with a child who would benefit from learning more emotional-regulation skills, please see AIDE Canada’s toolkit: Self-Regulation Toolkit

If you are having trouble sleeping over a long period of time, be sure to bring up your concerns with your doctor. Keeping track of how much sleep you get per night and how frequently you wake up in the middle of the night can help your doctor decide on the best way to help you get a better night’s sleep.

Additional Resources/Reading:

Working for Kids: Building Skills^TM

Better Nights, Better Days: A Program for Children with Neurodevelopmental Disorders

Public Health Ontario: Adverse Childhood Experiences (ACEs)- Interventions to Prevent and Mitigate Impact of ACE’s in Canada

Center for Disease Control: Adverse Childhood Experiences (ACEs)

References:

1. Hughes K, Bellis MA, Hardcastle KA, et al. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health 2:e356–66.
2. Vervoort-Schel, J., Mercera, G., Wissink, I., Van der Helm, P., Lindauer, R., & Moonen, X. (2021). Prevalence of and relationship between adverse childhood experiences and family context risk factors among children with intellectual disabilities and borderline intellectual functioning. Research in Developmental Disabilities, 113, 103935
3. Chapman DP, Wheaton AG, Anda RF, Croft JB, Edwards VJ, Liu Y, Sturgis SL, Perry GS. Adverse childhood experiences and sleep disturbances in adults. Sleep Med. 2011 Sep;12(8):773-9.
4. Kelly Sullivan, Haresh Rochani, Li-Ting Huang, Diane K Donley, Jian Zhang, Adverse childhood experiences affect sleep duration for up to 50 years later, Sleep, Volume 42, Issue 7, July 2019, zsz087
5. Teicher MH, Ohashi K, Khan A, Hernandez Garcia LC, Klengel T, Anderson CM, Silveri MM. Does sleep disruption mediate the effects of childhood maltreatment on brain structure? Eur J Psychotraumatol. 2018 Mar 28;8(Suppl 7):1450594. doi: 10.1080/20008198.2018.1450594. PMID: 29844885; PMCID: PMC5965034.
6. Cameron JL, Eagleson KL, Fox NA, Hensch TK, Levitt P. Social Origins of Developmental Risk for Mental and Physical Illness. J Neurosci. 2017 Nov 8;37(45):10783-10791. doi: 10.1523/JNEUROSCI.1822-17.2017. PMID: 29118206; PMCID: PMC5678010.
7. Ahmed-Leitao, F., Spies, G., van den Heuvel, L., & Seedat, S. (2016). Hippocampal and amygdala volumes in adults with posttraumatic stress disorder secondary to childhood abuse or maltreatment: A systematic review. Psychiatry Research: Neuroimaging, 256, 33-43.
8. Marco EM, Velarde E, Llorente R, Laviola G. Disrupted Circadian Rhythm as a Common Player in Developmental Models of Neuropsychiatric Disorders. Curr Top Behav Neurosci. 2016;29:155-181.