LAUSR

Sleep patterns may partially account for associations between early life adversity and poor health outcomes; however, few studies have empirically tested this hypothesis. We examined whether an index of sleep regularity mediated associations between child maltreatment (CM) and depression symptoms among emerging adults undergoing the major life transition of starting college. First-year college students (N=731; 41% male; 48% Non-Hispanic White, 21% Non-Hispanic Asian, 15% Hispanic all races, 5% Non-Hispanic Black, and 11% Non-Hispanic other races) completed daily sleep diaries (DSDs) for 9 weeks and completed the Childhood Trauma Questionnaire (CTQ) and Center for Epidemiologic Studies Depression Scale (CES-D) following DSD completion. DSD data were used to compute participants’ Sleep Regularity Index (SRI). We used a nonparametric SEM bootstrap approach to examine whether sleep regularity mediated associations between childhood trauma and depressive symptoms, controlling for sex, race/ethnicity, and US vs. international status. Separate models were run for CTQ total score and five CTQ subscale scores: emotional, physical, and sexual abuse, and physical and emotional neglect. The prevalence of moderate to severe CM was 20.7%, and 40% reported clinically significant depressive symptoms at the end of the assessment period. Significant indirect effects of CTQ total score (estimate=0.02, 95% CI=0.003, 0.036); emotional abuse (0.06 [0.004, 0.107]); physical abuse (0.08 [0.003, 0.164]); sexual abuse (0.06 [0.014, 0.114]); emotional neglect (0.04 [0.002, 0.075]) on greater depression symptoms through lower sleep regularity were observed; and we saw no significant indirect effect of physical neglect (0.04 [-0.015, 0.089]). The percentage of the total effect of CM (i.e., CTQ total score and subscale scores) on greater depressive symptoms accounted for by lower sleep regularity were CTQ total score: 6%; physical abuse: 24%; sexual abuse: 19%; emotional abuse: 7%; and emotional neglect: 5%. Variable sleep patterns account, in part, for associations between CM and depressive symptoms among first-year college students, with the largest effects observed for physical and sexual abuse. Sleep regularity should be included as a target in student health interventions on college campuses and may help buffer against poor mental health outcomes for students with CM. P20GM139743, MH079179, T32HD101392, P20GM139767.