Impact of Adverse Childhood Experiences on Hearing Impairment: The Mediating Influence of Sleep Disorders in a Chinese Population
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By
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Huan Chen
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November 18, 2025
Impact of Adverse Childhood Experiences on Hearing Impairment via Sleep Disorders
Overview
This study investigated the relationship between adverse childhood experiences (ACE) and hearing loss (HL) in middle-aged and older Chinese adults, examining sleep disorders as a potential mediator. Findings indicate that higher ACE scores are associated with increased risk of HL, and sleep disorders partially mediate this association.
Background
Adverse childhood experiences (ACE) encompass various negative events before age 18 and are prevalent globally, affecting physical and mental health long-term. Hearing loss (HL) has been linked to psychiatric disorders and sensory impairment, with emerging evidence suggesting sleep disorders may influence HL risk. This study uniquely explores whether sleep disorders mediate the relationship between ACE and HL using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS).
Data Highlights
| Variable | Measure | Details |
|---|---|---|
| Sample Size | 7,534 | Participants aged ≥45 years with complete data |
| ACE Score | 0-12 | 12 indicators including hunger, parental issues, abuse |
| Hearing Loss | Self-reported | Use of hearing aid or self-rated fair/poor hearing |
| Sleep Disorders | Frequency of restless sleep | Reported over past week; ≥1 day considered sleep disorder |
Key Findings
- 57.7% of the global population has experienced at least one ACE; 14.8% have four or more.
- Higher ACE scores correlate with increased odds of hearing loss in Chinese adults aged ≥45 years.
- Sleep disorders are more prevalent among individuals with higher ACE scores.
- Sleep disorders partially mediate the relationship between ACE and hearing loss, suggesting a mechanistic pathway.
- Adjusting for demographic and health covariates, the association between ACE and HL remains significant.
Clinical Implications
Clinicians should consider screening for history of adverse childhood experiences and sleep disorders in patients presenting with hearing impairment. Interventions targeting sleep quality may mitigate the risk or progression of hearing loss in individuals with high ACE exposure. Public health strategies addressing ACE reduction and sleep health promotion could reduce the burden of hearing impairment.
Conclusion
This study provides evidence that sleep disorders partially mediate the association between adverse childhood experiences and hearing loss in middle-aged and older adults. Addressing sleep disturbances may represent a viable pathway to reduce hearing impairment linked to early-life adversity.
References
- CHARLS Study and Related Literature (2014-2018) -- Impact of ACE on Hearing Loss and Sleep Disorders
Based on findings from:
Adverse childhood experiences and hearing loss: the mediating role of sleep disorders in a Chinese cohort
Huan Chen. Bmc Psychiatry, 2025.
https://link.springer.com/article/10.1186/s12888-025-07543-3
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