This study examines the association between adverse childhood events (ACEs) and chronic pain in adolescents, as well as between ACEs and anxiety and depressive symptoms in adolescents with chronic pain, and focus on the role of sleep disturbance as a mediating and moderating factor of these associations. The study draws upon cross-sectional data from 469 adolescents aged 13-18 years old and utilizes mediation and moderation models. The results suggest that sleep disturbance plays a significant mediating role in the association between ACEs exposure and chronic pain in adolescents, as well as in the association between ACEs exposure and depressive symptoms in adolescents with chronic pain. Additionally, sleep disturbance moderates the association between ACEs exposure and anxiety in adolescents with chronic pain. The study highlights the importance of addressing sleep disturbance as a potential preventive measure for chronic pain and psychological dysfunction in adolescents with a history of ACEs.