Summary The objectives were to explore the association between self‐reported adverse childhood experiences (ACE) and sleep in adults suffering from primary insomnia and to examine the impact of presleep stress on this relationship. Fifty‐nine patients with primary insomnia, aged 21–55 years, were administered the Childhood Trauma Questionnaire (CTQ) and then divided into two groups according to the achieved scores: with moderate/severe or low/no reports of ACE. The participants spent three consecutive nights in the sleep laboratory in order to record polysomnographic and actigraphic sleep parameters. A stress induction technique was administered by activating negative autobiographical memories immediately before sleep in the second or third night. Results show that 46% of the insomniac patients reported moderate to severe ACE. This group exhibited a significantly greater number of awakenings and more movement arousals compared to patients with low or no reports of ACE. Actigraphic data also indicated more disturbed sleep and increased nocturnal activity for the high‐ACE group. On the other hand, no specific group differences were found with regard to stress condition. The results support the assumption that it is possible to identify a subgroup among patients with primary insomnia who has experienced severe maltreatment in childhood and adolescence. This subgroup appears to differ in several sleep parameters, indicating a more disturbed sleep compared to primary insomniacs with low or no reports of ACE. With regard to sleep‐disturbing nightly patterns of arousal, parallels between individuals with high ACE and trauma victims as well as post‐traumatic stress disorder‐patients suggest themselves.

ACEs are associated with blunted endocrine and cardiovascular stress reactivity in young and healthy women. Adverse life events in childhood, particularly if they occur repeatedly and chronically, show a strong association with alterations in stress reactivity in adulthood, potentially predisposing for later mental or physical disorders.

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The present study examined to what extent adverse childhood experiences (ACE), in addition to demographic characteristics, current level of stress, depression, and arousability predisposition, are associated with sleep measures in adult insomnia. Thirty-nine adults suffering from primary insomnia completed self-report questionnaires assessing ACE, current level of stress, predisposition towards increased arousability, and depression. They were monitored for 7 consecutive nights at home with wrist actigraphs to evaluate objective sleep-related activity. Blockwise multiple regression analyses were performed to determine which variables were the most important predictors of sleep measures. ACE proved to be important predictors of actigraphically assessed sleep onset latency, sleep efficiency, number of body movements, and moving time, whereas the set of the remaining variables had no significant impact on these sleep measures. These findings suggest that there is an association between childhood maltreatment history and sleep in patients with primary insomnia. We presume that sleep-related nightly activity can be regarded as an aftereffect of long-lasting stressful experiences in childhood.

The present study aimed to investigate whether stress experienced early in life is associated with actigraphic and subjective sleep measures in a sample of adult psychiatric outpatients. A total of 48 psychiatric outpatients completed self-report questionnaires assessing current depression, current anxiety symptoms and stress load during childhood (before the age of 13 years), adolescence (between the age of 13 and 18 years) and adulthood (between the age of 19 and current age). Sleep-related activity was measured using 24-h wrist actigraphy over a 7-day period at home, during which participants also kept a sleep diary. High stress load in childhood, but not in adolescence, was associated with shortened actigraphically assessed total sleep time, prolonged sleep onset latency, decreased sleep efficiency and an increased number of body movements in sleep, even after accounting for the effects of later occurring stress and psychopathological symptoms such as depression and anxiety scores. Unexpectedly, no significant associations between early-life stress load and subjective sleep measures were found. Results are consistent with findings from previous studies indicating an association between childhood adversities and higher levels of nocturnal activity. The findings suggest that high stress load during childhood might be a vulnerability factor for sleep continuity problems in adulthood.