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Adverse childhood experiences are associated with adult sleep disorders: a systematic review
Open accessAbstract
Adverse childhood experiences (ACEs) represent substantial threats to public health and affect about 58% of youth in the US. In addition to their acute effects such as injury and physical trauma, ACEs are associated with an increased risk of several negative health outcomes throughout the life course. Emerging evidence suggests that sleep disorders may be one such outcome, but existing studies have not been systematically reviewed and summarized. We conducted a systematic review to summarize the evidence concerning the relationship between ACEs and sleep disorders and disturbances, with a focus on adult women. Original publications were identified through searches of the electronic databases MEDLINE, Embase, and Web of Science using the keywords "childhood," "adversity," "abuse," and "sleep" as well as searches of the reference lists of eligible studies. Studies evaluating ACEs that occurred before 18 years of age and sleep outcomes that were assessed at 18 years or older were adjudicated and included. A total of 30 publications were identified. Of the 30 studies, 28 were retrospective analyses and there was vast heterogeneity in the types of ACEs and sleep outcomes measured. The majority of retrospective studies (N = 25 of 28) documented statistically significant associations between sleep disorders including sleep apnea, narcolepsy, nightmare distress, sleep paralysis, and psychiatric sleep disorders with a history of childhood adversity. In many studies, the strengths of associations increased with the number and severity of adverse experiences. These associations were corroborated by the two prospective studies published to date. Notably, investigators have documented statistically significant associations between family conflict at 7-15 years of age and insomnia at 18 years of age (odds ratio, OR = 1.4; 95% confidence interval, CI = 1.2-1.7) and between childhood sexual abuse and sleep disturbances 10 years later in adult women (β = 0.24, p <0.05). There is a growing scientific body of knowledge suggesting an association between ACEs and multiple sleep disorders in adulthood. The available evidence indicates the need to develop treatment strategies such as trauma-informed care for survivors of abuse who suffer from sleep disorders and disturbances. Further, longitudinal studies among diverse populations are needed to improve the overall understanding of this association and to investigate potential gender and racial/ethnic disparities in the strength of the association.
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“Sleep disorders are among the many illnesses linked to early adversity [reviews in Ref. (47, 48)].”
From The Stress Acceleration Hypothesis of Nightmares (2017) · cites this paper as [48]
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Metadata
- Authors
- Kajeepeta, S., Gelaye, B., Jackson, C. L., & Williams, M. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Kajeepeta, Sandhya
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 16
- Issue
- 3
- Pages
- 320-330
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC4635027
- OpenAlex
- W2150936363
- Cited by
- 385
- References
- 78
- Citations by year
- 2026: 27 · 2025: 40 · 2024: 59 · 2023: 46 · 2022: 53 · 2021: 45 · 2020: 35 · 2019: 33 · 2018: 20 · 2017: 11 · 2016: 11 · 2015: 5
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NICHD (R01-HD-059835)
- National Center for Advancing Translational Sciences (8UL1TR000170-07)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- adverse childhood experiences, sleep disorders, insomnia, sleep apnea, narcolepsy, nightmare distress, sleep paralysis, child sexual abuse, family conflict, adult women, trauma-informed care, childhood adversity
- MeSH terms
- Adolescent, Adult, Age Factors, Child, Child Abuse, Female, Humans, Life Change Events, Male, Sex Factors, Sleep Wake Disorders, Family Conflict
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