Exposure to childhood adversity in the home may be related to poorer sleep, even in samples without sleep disorders or psychiatric illness. Sleep health is a construct that considers dimensions of both nighttime and daytime sleep (i.e., regularity, satisfaction, alertness, timing, efficiency, duration). This study examined the relationship between cumulative childhood adversity (i.e., a sum of different types of adversities) and sleep health, as well as mediators and moderators of this relationship, including vigilance for threat, childhood SES, community adversities, body mass index, and symptoms of depression, anxiety, and PTSD in a sample of 540 healthy undergraduates aged 18-28 years old (50% female; 29% non-white). Online surveys assessed childhood adversity before age 18 and current sleep, mood, vigilance for threat, and health. Survey sleep health was measured using the “RUSATED” scale (Buysse, 2014). A subsample (n=114) completed a laboratory protocol that measured behavioral and physiological vigilance for threat, and a weeklong sleep protocol (actigraphy and daily diaries). Primary analyses examined a second-order latent factor of sleep health that combined survey, actigraphy, and diary measures of the six sleep health dimensions. Supplemental analyses examined the total sleep health score on the RUSATED survey, as well as total scores when RUSATED cut-offs for each sleep dimension were applied to actigraphy and diary data. Structural equation modeling (with bootstrapping for mediation models) and linear regressions were used to examine the relationship between childhood adversity and sleep health. Overall, 52% of the sample reported one or more childhood adversities. Childhood adversity was related to poorer latent sleep health and survey-reported RUSATED sleep health total score after adjustment for sociodemographic, health, and psychosocial covariates. Mediation and moderation hypotheses were largely unsupported, with two exceptions: PTSD partially mediated the relationship between childhood adversity and diary-derived sleep health total score, and low childhood SES moderated the relationship between adversity and survey sleep health total score, but this interaction was not probed as less than 5% of participants reported low SES. The sleep health construct may provide a nuanced way to study sleep patterns and ultimately guide intervention efforts that may mitigate downstream risk of poor health outcomes
