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Behav Sleep Med. 2009;7(4):223-44. doi: 10.1080/15402000903190207.

Sleep as a mediator in the pathway from violence-induced traumatic stress to poorer health and functioning: a review of the literature and proposed conceptual model.

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Center for Clinical Investigation, Case School of Medicine, Cleveland, OH 44106, USA.


Millions of children are exposed to various forms of violence every year, resulting-for many of them-in psychological problems, decreased social functioning, and poorer overall quality of their relationships and lives. This article reviews the scientific literature investigating the role of sleep as a key mediator in the pathway between violence-induced traumatic stress and resulting negative health and behavioral outcomes. Based on evidence revealed by this review and general research on how exposure to violence influences child health and development, a conceptual model is proposed that posits sleep's role as an important mediator of health effects and that incorporates other factors believed to shape linkages between exposure to violence and health and behavioral outcomes in children. Recommendations are given for future research to test the proposed model.

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