Objective prenatal sleep and adverse childhood experiences in a proof-of-concept observational mixed methods study

Jessica Rohr; Bishal Lamichhane; Ashutosh Sabharwal; Nicole Bartek; Katelynn Bourassa; Yiwen Geng; Akane Sano; Alok Madan

doi:10.1016/j.isci.2025.114481

Objective prenatal sleep and adverse childhood experiences in a proof-of-concept observational mixed methods study

iScience. 2025 Dec 18;29(1):114481. doi: 10.1016/j.isci.2025.114481. eCollection 2026 Jan 16.

Authors

Jessica Rohr¹, Bishal Lamichhane^{1

2}, Ashutosh Sabharwal², Nicole Bartek¹, Katelynn Bourassa¹, Yiwen Geng², Akane Sano², Alok Madan¹

Affiliations

¹ Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX 77030, USA.
² Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, USA.

Abstract

Adverse childhood experiences (ACEs) have been proposed as a contributor to maternal health risk, and sleep is one pathway through which early adversity may influence physiological functioning during pregnancy. We examined whether ACEs were associated with objectively measured sleep patterns in an observational study of 50 first-time pregnant adults who wore a physiological monitoring device continuously for 30 days during the second trimester. The wearable data provided nightly sleep stage estimates, heart rate, and physical activity. Rapid eye movement (REM) sleep duration emerged as the variable most strongly associated with ACE exposure. Participants with ACEs showed greater REM sleep duration and a larger increase in REM sleep across the monitoring period. Classification models using REM duration distinguished participants with and without ACEs with high accuracy (75.56%), and ACE was a significant predictor of REM duration in regression modeling. These findings suggest a physiological sleep signature linked to early adversity during pregnancy.

Keywords: biological sciences; health sciences; psychiatry; psychosocial factor.