0104 Biological Embedding and Sleep Quality in Adulthood: Evidence from a 30-year Prospective Longitudinal Cohort Study
Abstract
Attenuation over the life course of hypothalamic-pituitary-adrenal (HPA) axis activity, such as reduced cortisol secretion, represents biological embedding of early-life stress. Biological embedding is implicated in myriad health concerns including disruptive sleep patterns. We hypothesized that attenuation of cortisol over the first half of the life-course will be negatively correlated with objectively indicated sleep quality in adulthood.
Cohort participants included females referred by child welfare agencies for having experienced intra-family childhood sexual abuse (CSA) at mean age 10.5 years. A counterfactual group of non-abused females from the same zip codes were demographically matched. The cohort was assessed at 7 timepoints across development longitudinally from 1987-2019. Resting cortisol was obtained through blood (waves 1-3) and saliva (waves 4-6). A formula approved by the US FDA was employed to convert salivary cortisol concentrations to blood-based equivalents: (serum µg/dL) = 5.177 + 15.132*(saliva µg/dL). Using a bilinear spline model – a model for tracking trajectories at different phases of development – pre-knot slopes (rates of change during childhood of cortisol, indicative of HPA attenuation and biological embedding) from waves 1 to 6 (or ages 6-32) were extracted. Wave 7 (mean age 36.1 years) included wrist actigraphy for a week. Ordinary Least Squares (OLS) regression examined whether cortisol slope from ages 6 to 32 predicted adult sleep.
We found…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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