Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA.
Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA.
Sleep Med. 2022 Jun;94:70-75. doi: 10.1016/j.sleep.2022.03.026. Epub 2022 Apr 2.
Survivors of childhood abuse are prone to adult insomnia, but the mechanisms for this development are poorly understood. Abuse that occurs during sensitive developmental periods might affect risk for insomnia by impacting emerging stress regulatory processes. Sleep reactivity refers to the sensitivity of the sleep system to stress and is a robust risk factor for insomnia. Recent evidence shows stress exposure itself worsens sleep reactivity, thereby increasing insomnia vulnerability. In this preliminary study, we hypothesized the association between childhood abuse experiences and adult insomnia would be mediated through greater sleep reactivity.
Community adults were recruited from the United States during the COVID-19 pandemic between June 2020 and June 2021 (N = 241, 88% female, M = 39, SD = 13.40). Participants completed a cross-sectional survey that included the Childhood Trauma Questionnaire, Ford Insomnia Response to Stress Test, Insomnia Severity Index, and a measure of general COVID-19 stress.
Reporting more frequent childhood emotional, physical, or sexual abuse was associated with more severe insomnia during the COVID-19 pandemic. Only childhood emotional and physical (but not sexual) abuse histories were associated with greater sleep reactivity, which exerted an indirect effect on the relationships between these two abuse types and insomnia symptoms. These findings were robust to the effects of gender, age, and stress about the COVID-19 pandemic.
This preliminary study suggests recurrent emotional and physical abuse in childhood might promote later insomnia through heightened sleep reactivity. Stress management interventions could be important to prevent insomnia for abuse survivors by bolstering resilience of the sleep system.
儿童期受虐幸存者易患成人失眠症，但对此发展机制的了解甚少。在敏感的发育阶段发生的虐待可能会通过影响新兴的应激调节过程来影响失眠的风险。睡眠反应性是指睡眠系统对压力的敏感性，是失眠的一个强有力的风险因素。最近的证据表明，压力暴露本身会使睡眠反应性恶化，从而增加失眠的脆弱性。在这项初步研究中，我们假设儿童期虐待经历与成人失眠之间的关联是通过更大的睡眠反应性来介导的。
在 2020 年 6 月至 2021 年 6 月期间，我们在美国从社区招募了成年人（N=241，88%为女性，M=39，SD=13.40）。参与者完成了一项横断面调查，其中包括儿童期创伤问卷、福特失眠应激反应测试、失眠严重程度指数和一般 COVID-19 应激量表。
报告更频繁的儿童期情绪、身体或性虐待与 COVID-19 大流行期间更严重的失眠有关。只有儿童期情绪和身体（但不是性）虐待史与更高的睡眠反应性相关，这对这两种虐待类型与失眠症状之间的关系产生了间接影响。这些发现不受性别、年龄和对 COVID-19 大流行的压力的影响。
这项初步研究表明，儿童期反复发生的情绪和身体虐待可能通过提高睡眠反应性促进后期失眠。压力管理干预措施对于通过增强睡眠系统的弹性来预防受虐待者的失眠可能很重要。
