Childhood adversity and insomnia in adolescence

Abstract

Objective To evaluate the association between exposure to childhood adversity and insomnia, with an emphasis on the role of adversity type, timing, and accumulation (i.e. the number of specific types of adversities the child reported being exposed to). Methods Our analytic sample comprised 9,582 adolescents from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally-representative population-based sample. We examined the association between 18 different types of retrospectively-reported adversities (capturing interpersonal violence, accidents and injuries, social network or witnessing events, other adverse events) and risk of self-reported past-year insomnia. We also examined whether the age at first exposure to adversity was associated with risk for insomnia, and whether exposure to a greater number of different types of adversities (i.e. accumulation) conferred an elevated risk for insomnia. Additionally, we performed a sensitivity analysis excluding adolescents with a past-year diagnosis of major depression, dysthymia, post-traumatic stress disorder, or generalized anxiety disorder. Results Almost one third of adolescents reported insomnia, with a higher prevalence among girls and those from racial/ethnic minority groups. Adolescents exposed to at least one childhood adversity of any type (59.41%) were more likely than their non-exposed peers to experience insomnia (across adversities, prevalence ratios ranged from 1.31 to 1.89). Risk of insomnia differed based on the age at first exposure to adversity as well as the type of adversity. Adolescents exposed to a greater number of different types of adversities had a higher risk of insomnia compared to those experiencing fewer adversities. These results were similar, by and large, to those obtained after excluding adolescents with at least one of the four past-year psychiatric disorders. Conclusions Exposure to adversity confers an elevated risk for insomnia. This association varied by type, timing, and accumulation of exposure and did not appear to be driven by psychiatric disorders. Given the well-documented physical and mental health consequences of insomnia, such findings add further support to the need for practitioners to screen children for exposure to childhood adversity and insomnia symptoms.

Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation

“…Direct and indirect human and animal stress research supports the important supraordinate role of CS on stress system and GCs, linking circadian misalignment in ELS/CT-related pathophysiology and potentially resulting in the extensive comorbidities of ELS/CT through an impaired homeostatic balance. Some animal (332), but-most importantly-numerous human studies including large cohorts, have repeatedly confirmed that ELS/CT is independently associated with enduring adult sleep disruption including global sleep pathology (i.e., insomnia), as well as specific types of sleep problems, such as shortened total sleep time, prolonged sleep onset latency, decreased sleep efficiency, increased number of awakenings, nightmare related distress, sleep apnea and higher nocturnal activity in a probably dose-response manner (333)(334)(335)(336)(337)(338)(339)(340)(341)(342)(343)(344).…”

Insomnia in Adolescence

“…Adolescents with neurodevelopmental disorders other than ADHD are also at risk for sleep difficulties [ 54 , 55 ]. This includes Autism Spectrum Disorders, Cerebral Palsy, Fetal Alcohol Syndrome, Down Syndrome, and other conditions manifesting early in childhood with significant cognitive and emotional/behavioral difficulties.…”

“…Other populations at risk for insomnia include children with chronic illnesses [ 59 , 60 , 61 ] and in difficult social situations such as poverty and food scarcity [ 62 ] and in turbulent home environments due to an array of issues as severe as exposure to violence [ 62 , 63 ]. Many of these insomnia symptoms are inextricable from the PTSD, depression and anxiety that these adolescents also face [ 55 , 62 ].…”

Early parental positive personality and stress: Longitudinal associations with children's sleep

“…Prior research has connected adversity early in life to poor sleep (e.g., disturbances [trouble falling or staying asleep], insomnia) in adolescence and adulthood (Chapman et al ., , ; Kajeepeta, Gelaye, Jackson, & Williams, ; Wang, Raffeld, Slopen, Hale, & Dunn, 2016), suggesting a link between the early environment and sleep later in life. Negative childhood experiences have been related to troubled sleep, defined as self‐reports of difficulty falling or staying asleep, and an increased likelihood of poor sleep quality among adults (Baiden, Fallon, den Dunnen, & Boateng, ; Koskenvuo, Hublin, Partinen, Paunio, & Koskenvuo, ).…”