Elsevier

Sleep Medicine

Volume 16, Issue 10, October 2015, Pages 1274-1280
Sleep Medicine

Original Article
Childhood abuse is associated with stress-related sleep disturbance and poor sleep quality in pregnancy

https://doi.org/10.1016/j.sleep.2015.07.004Get rights and content

Highlights

  • History of childhood abuse (CA) is associated with sleep disturbances during pregnancy.

  • CA was associated with 1.65-fold increased odds of stress-related sleep disturbance.

  • CA was associated with 2.11-fold increased odds of poor sleep quality.

  • The odds of sleep disturbances were much stronger for those who experienced higher numbers of CA events.

  • Trauma-informed care for sleep disturbances induced by childhood trauma is needed.

Abstract

Objectives

Childhood abuse is associated with increased risks of adult psychiatric disorders and physical health conditions. Mounting evidence documents associations of childhood abuse with sleep disturbances in adulthood. However, to date, no study has evaluated associations of childhood abuse and sleep disturbances among pregnant women.

Methods

This cross-sectional study included 634 pregnant Peruvian women. To collect information regarding socio-demographic characteristics, history of childhood abuse, and complaints of sleep disturbances, face-to-face interviews were conducted with women in early pregnancy. Ford Insomnia Response to Stress Test (FIRST-S) and the Pittsburgh Sleep Quality Index (PSQI-S), translated from English to Spanish, were used to assess stress-related sleep disturbance and sleep quality, respectively. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CIs).

Results

Women who experienced any childhood abuse had a 1.65-fold increased odds of stress-related sleep disturbance (aOR = 1.65; 95% CI: 1.15–2.38) and 2.11-fold increased odds of poor sleep quality during early pregnancy (aOR = 2.11; 95% CI: 1.35–3.30) as compared with women who reported no abuse. Women who reported both physical and sexual abuse during childhood were more than twice as likely to suffer from stress-related sleep disturbance (aOR = 2.26; 95% CI: 1.44–3.53) and poor sleep quality (aOR = 2.43; 95% CI: 1.45–4.09) in comparison to women who reported no childhood abuse.

Conclusions

A history of childhood abuse is associated with increased odds of stress-related sleep disturbance and poor sleep quality during pregnancy. These findings, if replicated, should be used to inform the development of trauma-informed care for such sleep disturbances induced by childhood trauma.

Section snippets

Background

Pregnancy is a period characterized by multiple physiologic changes, including variations in energy and sleep demands, often leading to sleep disturbances [1]. Available data suggest that sleep disturbances during pregnancy are associated with adverse perinatal outcomes, including maternal depression, preeclampsia, and preterm birth [2], [3], [4]. For example, investigators have reported that short sleep duration (six or fewer nightly hours) in early pregnancy is associated with elevated

Results

Table 1 shows the socio-demographic and reproductive characteristics of the population under study. The mean age of participants was 28.8 years (standard deviation = 6.6 years); the majority of participants were married or living with a partner (79.7%) and had at least seven years of education (95.7%), while half (49.8%) of them reported that they were employed during pregnancy. Approximately, 48% of participants reported having difficulty paying for basic necessities such as food items. The

Discussion

Our study extends the literature by documenting increased odds of stress-related sleep disturbance and poor sleep quality among pregnant women with a history of childhood abuse. Childhood abuse was associated with higher odds of stress-related sleep disturbance (aOR = 1.65; 95% CI: 1.15–2.38) and with poor sleep quality (aOR = 2.11; 95% CI: 1.35–3.30) during early pregnancy; these associations were only partially explained by antepartum depression. Recent abuse by an intimate partner was not

Conflict of interest

None declared.

The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2015.07.004.

. ICMJE Form for Disclosure of Potential Conflicts of Interest form.

Acknowledgments

This study was supported by awards from the National Institutes of Health (NIH; R01-HD-059835, T37-MD000149 and K01MH100428). The NIH had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru, and Instituto Materno Perinatal, Peru, for their expert technical

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