Adverse childhood experiences and sleep disorders among Tunisian adolescents: The mediating role of internet addiction

Background: Adverse childhood experiences (ACEs) are a prevalent health problem worldwide. Different side effects have been linked to this issue such as sleep disorders. This matter is well known. However, its influencing mechanisms are not well investigated in literature.

Objective: To investigate the mediating role of internet addiction in the relation between adverse childhood experiences (ACEs) and sleep disorders among a population of high-school students in the region of Gafsa (Tunisia).

Participants and setting: We performed a cross-sectional study, in February 2020, including adolescents registered in all secondary schools of Gafsa city.

Methods: Sleep disorders were evaluated via the Pittsburgh Sleep Quality Index, internet addiction via the Internet Addiction Test and adverse childhood experiences via the Adverse Childhood Experiences-International Questionnaire.

Results: A total of 414 students were enrolled in our study with a mean age of 17.18 ± 1.5 years. Exposure to intra-familial violence was more reported than social adversities with 99.1 % and 84 % respectively. Males showed higher rates of internet addiction (82.9 % vs 78.3 %, p < 0.001). Sleep disorders were reported in 94 % of students, predominantly among females (95.4 % vs 91 %, p < 0.001). Our results revealed that ACEs predict sleep disturbances through internet addiction (% mediation =18.3 %, p = 0.005). More particularly, an important mediation effect of internet addiction on the relationship between ACEs and sleep disorders was found among females (% mediation =30 %).

Conclusion: Internet addiction was found to be a mediating factor in the relation between ACEs and sleep disturbances among Gafsa high school students.