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Introduction <p>Adverse childhood experiences (ACE) are robustly associated with chronic diseases, yet their link to hearing loss (HL) and potential mediators remains poorly understood. We tested whether sleep disorders mediate the ACE–HL relationship in middle-aged and older Chinese adults.</p> Methods <p>Data from 7,534 CHARLS participants aged ≥ 45 years were analyzed. ACE were retrospectively assessed via 12 items and summarized as a continuous score (0–12) and quartiles. HL was defined by self-reported fair/poor hearing or hearing-aid use. Sleep disorders were indicated by restless sleep ≥ 1&#xa0;day/week. Logistic regression and causal mediation models adjusted for sociodemographic, behavioral and clinical covariates.</p> Results <p>Mean ACE score was 3.6 ± 1.8; 47.2% reported sleep disorders. Participants with ≥ 5 ACE had 1.63-fold higher odds of HL than those with 0 ACE (95% CI: 1.22–2.18; <i>p</i> &lt; 0.001). Sleep disorders mediated 13.3% (95% CI: 5.2–28.5%) of the total ACE effect on HL. Stratified analyses showed consistent associations across subgroups.</p> Discussion <p>ACE increase HL risk both directly and indirectly through sleep disturbances. Targeting sleep problems among individuals with high ACE exposure may attenuate HL progression and offers a novel public-health strategy to reduce age-related hearing impairment.</p> Clinical trial number <p>Not applicable.</p>

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Adverse childhood experiences and hearing loss: the mediating role of sleep disorders in a Chinese cohort

  • 期刊论文

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  • 发表日期：

    2025年11月18日

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  • Huan Chen

摘要

Introduction

Adverse childhood experiences (ACE) are robustly associated with chronic diseases, yet their link to hearing loss (HL) and potential mediators remains poorly understood. We tested whether sleep disorders mediate the ACE–HL relationship in middle-aged and older Chinese adults.

Methods

Data from 7,534 CHARLS participants aged ≥ 45 years were analyzed. ACE were retrospectively assessed via 12 items and summarized as a continuous score (0–12) and quartiles. HL was defined by self-reported fair/poor hearing or hearing-aid use. Sleep disorders were indicated by restless sleep ≥ 1 day/week. Logistic regression and causal mediation models adjusted for sociodemographic, behavioral and clinical covariates.

Results

Mean ACE score was 3.6 ± 1.8; 47.2% reported sleep disorders. Participants with ≥ 5 ACE had 1.63-fold higher odds of HL than those with 0 ACE (95% CI: 1.22–2.18; p < 0.001). Sleep disorders mediated 13.3% (95% CI: 5.2–28.5%) of the total ACE effect on HL. Stratified analyses showed consistent associations across subgroups.

Discussion

ACE increase HL risk both directly and indirectly through sleep disturbances. Targeting sleep problems among individuals with high ACE exposure may attenuate HL progression and offers a novel public-health strategy to reduce age-related hearing impairment.

Clinical trial number

Not applicable.