Sleep: An unplayed ace in research and treatment of youth with ACEs

Although Adverse Childhood Experiences (ACEs) affect many youth, there are not currently standardized treatments offered following ACE screenings. Sleep interventions may serve as a valuable first-line intervention in high-ACE cohorts, as sleep may protect against negative physical and mental health effects of adversity. Sleep interventions can also be offered succinctly and affordably, which can address systemic barriers to care often encountered in high-risk populations. This discussion considers biological and psychological evidence for sleep treatment improving symptoms associated with adversity, reviews existing sleep interventions, and calls for further research into trauma-informed and culturally-informed interventions which can be tailored to specific needs of individuals with histories of adversity. Challenges to measurement of intervention efficacy are also discussed, including multidimensional modelling of sleep health, curvilinear nature of sleep-related trends, and importance of symptom vs. diagnostic monitoring in groups with potentially lower access to assessment and care.