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Sleep. 2019 Aug 1;42(8). pii: zsz108. doi: 10.1093/sleep/zsz108.

Traumatic childhood experiences and multiple dimensions of poor sleep among adult women.

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Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC.
Social & Scientific Systems, Inc, Durham, NC.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
4Intramural Program, National Institute on Minority Health and Health Disparities, Department of Health and Human Services, Bethesda, MD.



Exposure to traumatic childhood experiences (TCEs) may contribute to poor sleep in adulthood. Previous studies have been limited to mainly investigating physical and sexual abuse and did not consider betrayal trauma, or whether the victim regarded the perpetrator as someone socially close to them, the age group at occurrence, and trauma-related distress/anxiety.


We used a large cohort of US women, 35-74 years old, enrolled in the Sister Study from 2003 to 2009. Self-reports of specific TCEs occurring before the age of 18 years included sexual, physical, and psychological/emotional trauma; natural disasters; major accidents; and household dysfunction. Participants self-reported average sleep duration (short: <7 hours vs recommended: 7-9 hours), sleep onset latency (SOL) at least 30 vs less than 30 minutes, at least 3 night awakenings once asleep at least 3 times/week (Night awakenings [NA], yes vs no), and napping at least 3 vs less than 3 times/week.


Among 40 082 women, 55% reported a TCE, with 82% reporting betrayal trauma. Compared to women reporting no TCE, women with any TCE were more likely to report short sleep (prevalence ratio [PR] = 1.08, [95% confidence interval (CI) = 1.04 to 1.11]), longer SOL (1.11, [1.06 to 1.16]), frequent NAs (1.06, [1.00 to 1.11]), and frequent napping (1.05, [0.99 to 1.12]). The relationship between experiencing any TCE and short sleep was stronger for TCEs by a perpetrator considered socially close vs not close (1.12, [1.09 to 1.16]), SOL (1.27, [1.22 to 1.33]), NA (1.20, [1.14 to 1.27]), and napping (1.24, [1.17 to 1.32]).


TCEs were associated with poor sleep in women with greater impact when the perpetrator was regarded as close. More research is warranted to better understand pathways between childhood trauma and sleep health in adulthood to develop effective interventions.


adult survivors of child adverse events; betrayal trauma; child abuse; sleep; trauma; women


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