Jakubowski Karen, Riedmann Carly A, Chang Yuefang, Koenen Karestan C, Maki Pauline M, Thurston Rebecca C
From the Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA.
Menopause. 2025 Mar 1;32(3):207-216. doi: 10.1097/GME.0000000000002480. Epub 2025 Feb 21.
Whereas some work links trauma exposure to poor subjective sleep quality, studies largely rely upon limited trauma measures and self-reported sleep at one time point. It is unknown whether trauma is related to persistent poor sleep, whether associations differ based on childhood versus adulthood trauma, and whether trauma exposure is related to poorer objectively assessed sleep. We tested whether childhood or adult trauma associated with persistent poor objectively and subjectively measured sleep at two time points in midlife women.
One hundred sixty-seven women aged 40-60 at baseline were assessed twice 5 years apart. At baseline, women reported childhood trauma (Child Trauma Questionnaire), adult trauma (Brief Trauma Questionnaire), demographics, depressive symptoms, apnea symptoms, and medical history, and provided physical measures. At both visits, women completed 3 days of actigraphy (total sleep time [TST], wake after sleep onset [WASO]) and reported sleep quality (Pittsburgh Sleep Quality Index). Relations of childhood and adult trauma exposure, respectively, with persistent poor sleep at both baseline and follow-up visits (TST [<6 hours], WASO [>30 minutes], Pittsburgh Sleep Quality Index [>5]) were assessed in logistic regression models, adjusted for age, race/ethnicity, education, body mass index, sleep medications, nightshift work, apnea, depressive symptoms, vasomotor symptoms, and alcohol use.
Childhood trauma was related to persistent high WASO (odds ratio [95% confidence interval] = 2.16 [1.04-4.50], P = 0.039, multivariable). Adult trauma was related to persistent poor sleep quality (odds ratio [95% confidence interval] = 2.29 [1.07-4.93], P = 0.034, multivariable). Trauma was unrelated to persistent short TST.
Childhood and adult trauma, respectively, were related to persistent poor objective sleep continuity and subjective sleep quality in midlife women, independent of risk factors.
虽然一些研究将创伤暴露与较差的主观睡眠质量联系起来，但这些研究大多依赖有限的创伤测量方法以及在单一时间点的自我报告睡眠情况。目前尚不清楚创伤是否与持续的睡眠不佳有关，基于童年创伤与成年创伤的关联是否存在差异，以及创伤暴露是否与客观评估的较差睡眠有关。我们测试了童年或成年创伤是否与中年女性在两个时间点持续存在的客观和主观测量的睡眠不佳有关。
167名基线年龄在40至60岁之间的女性，每隔5年接受两次评估。在基线时，女性报告童年创伤（儿童创伤问卷）、成年创伤（简易创伤问卷）、人口统计学信息、抑郁症状、呼吸暂停症状和病史，并提供身体测量数据。在两次访视时，女性均完成3天的活动记录仪监测（总睡眠时间 [TST]、睡眠开始后觉醒时间 [WASO]）并报告睡眠质量（匹兹堡睡眠质量指数）。在逻辑回归模型中评估童年和成年创伤暴露分别与基线和随访时持续存在的睡眠不佳（TST [<6小时]、WASO [>30分钟]、匹兹堡睡眠质量指数 [>5]）之间的关系，并对年龄、种族/民族、教育程度、体重指数、睡眠药物、夜班工作、呼吸暂停、抑郁症状、血管舒缩症状和饮酒情况进行调整。
童年创伤与持续较高的WASO相关（比值比 [95%置信区间] = 2.16 [1.04 - 4.50]，P = 0.039，多变量分析）。成年创伤与持续较差的睡眠质量相关（比值比 [95%置信区间] = 2.29 [1.07 - 4.93]，P = 0.034，多变量分析）。创伤与持续较短的TST无关。
童年和成年创伤分别与中年女性持续较差的客观睡眠连续性和主观睡眠质量相关，且独立于风险因素。
