Increased Nocturnal Activity and Impaired Sleep Maintenance in Abused Children

Glod, Carol A.; Teicher, Martin H.; Hartman, Carol R.; Harakal, Thomas

doi:10.1097/00004583-199709000-00016

Cited by 166 publications

(86 citation statements)

References 26 publications

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“…These findings are consistent with prior reports showing alterations in actigraph-assessed sleep measures in psychiatrically hospitalized maltreated children (Glod et al, 1997; Sadeh et al, 1995) and in adult outpatients (Schafer & Bader, 2013). Hence, these results extend prior findings to include maltreated individuals living in the community and not currently in psychiatric treatment.…”

Section: Discussionsupporting

confidence: 93%

“…Objective assessment of sleep using ambulatory activity monitors (actigraphs) show that maltreated children have sleep disruptions most consistently reflected in reduced sleep efficiency, and that this was more strongly associated with degree of exposure to physical abuse than sexual abuse or PTSD (Glod, Teicher, Hartman, & Harakal, 1997; Sadeh et al, 1995). Sleep impairment is a highly enduring effect of maltreatment, quite discernible even 10 years after disclosure of substantiated events (Noll, Trickett, Susman, & Putnam, 2006).…”

Section: Introductionmentioning

confidence: 99%

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Does sleep disruption mediate the effects of childhood maltreatment on brain structure?

Teicher

Ohashi

Khan

et al. 2017

European Journal of Psychotraumatology

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Background: Childhood maltreatment is associated with alterations in morphology of stress susceptible brain regions. Maltreatment is also known to markedly increase risk for psychopathology and to have an enduring disruptive effect on sleep. Objective: To determine whether abnormalities in sleep continuity have effects on brain morphometry and to evaluate the extent to which sleep impairments mediate the effects of maltreatment on brain structure. Method: Maltreatment and Abuse Chronology of Exposure (MACE) scale ratings, actigraph-assessed sleep and 3T MRI were obtained on N = 37 18–19-year-old participants recruited from the community (N = 34 with neuroimaging). Results: Fourteen participants had no history of maltreatment while N = 23 were exposed, on average, to 4.7 types of maltreatment. Multiplicity of maltreatment was strongly associated with reduced sleep efficiency, increased wake after sleep onset time and number/duration of awakenings, which were independent of effects of maltreatment on depression and anxiety. The most important predictors of impaired sleep were exposure to parental non-verbal emotional abuse at 9–10 years of age. Reduced sleep efficiency correlated with reduced grey matter volume in hippocampus including CA1 subfield, molecular layer and dentate gyrus as well as inferior frontal gyrus and insula. Sleep mediated 39–46% of the effects of maltreatment on volume of hippocampal structures and inferior frontal gyrus. Conclusions: Actigraph-assessed sleep is disrupted in maltreated late teens and mediates a significant portion of the effects of maltreatment on hippocampal volume. Studies are needed to assess whether efforts to enhance sleep in maltreated children can pre-empt or ameliorate neurobiological consequences of maltreatment.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Does sleep disruption mediate the effects of childhood maltreatment on brain structure?

Teicher

Ohashi

Khan

et al. 2017

European Journal of Psychotraumatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although abused children with and without PTSD had significantly more sleep impairments than controls, when the authors compared the abused PTSD and non-PTSD groups, they found more sleep impairments in the non-PTSD group. 73 This suggests that the sleep disturbances observed may be more related to abuse than to the presence of PTSD per se. Still, the sample sizes were quite small in both these studies, 72,73 and more in-depth, larger studies are required to further address this important issue.…”

mentioning

confidence: 99%

“…73 This suggests that the sleep disturbances observed may be more related to abuse than to the presence of PTSD per se. Still, the sample sizes were quite small in both these studies, 72,73 and more in-depth, larger studies are required to further address this important issue.…”

mentioning

confidence: 99%

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Sleep Disturbance in Pediatric PTSD: Current Findings and Future Directions

Kovachy

O’Hara

Hawkins

et al. 2013

Journal of Clinical Sleep Medicine

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Many studies have provided strong evidence of a fundamental and complex role for sleep disturbances in adult posttraumatic stress disorder (PTSD). Investigations of adult PTSD using subjective and objective measures document sleep architecture abnormalities and high prevalence of sleep disordered breathing, periodic limb movement disorder, nightmares, and insomnia. PTSD treatment methods do appear to signifi cantly improve sleep disturbance, and also studies suggest that treatments for sleep disorders often result in improvements in PTSD symptoms. Further, the most recent evidence suggests sleep abnormalities may precede the development of PTSD. Given the importance of sleep disorders to the onset, course, and treatment of adult PTSD, examination of sleep disturbances far earlier in the life course is imperative. Here we review the literature on what we know about sleep disturbances and disorders in pediatric PTSD. Our review indicates that the extant, empirical data examining sleep disturbance and disorders in pediatric PTSD is limited. Yet, this literature suggests there are signifi cantly higher reports of sleep disturbances and nightmares in children and adolescents exposed to trauma and/or diagnosed with PTSD than in non-trauma-exposed samples. Sleep questionnaires are predominantly employed to assess sleep disorders in pediatric PTSD, with few studies utilizing objective measures. Given the important, complex relationship being uncovered between adult PTSD and sleep, this review calls for further research of sleep in children with PTSD using more specifi c subjective measures and also objective measures, such as polysomnography and eventually treatment trial studies.

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Objective evidence of sleep disturbance in women with posttraumatic stress disorder

Calhoun

Wiley

Dennis

et al. 2007

Journal of Traumatic Stress

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Although sleep disturbance is considered a hallmark of posttraumatic stress disorder (PTSD), objective evidence for sleep disturbance in patients with PTSD has been equivocal. The goal of the current investigation was to objectively examine sleep disturbance among women with PTSD in their home environment. Women with PTSD (n = 30) and a control group (n = 22) completed three nights of actigraphy monitoring. Results from actigraphy indicated that women with PTSD had poorer sleep efficiency, increased sleep latency, and more restless sleep. Actigraphy measures were moderately correlated with self-report sleep-log data, but were unrelated to scores on the Pittsburgh Sleep Quality Index. The current study provides evidence that women with PTSD have objectively measured sleep disturbance in their normal environment at home. Disturbed sleep may have important implications for the health and well-being of individuals with PTSD.

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Increased Nocturnal Activity and Impaired Sleep Maintenance in Abused Children

Cited by 166 publications

References 26 publications

Does sleep disruption mediate the effects of childhood maltreatment on brain structure?

Does sleep disruption mediate the effects of childhood maltreatment on brain structure?

Sleep Disturbance in Pediatric PTSD: Current Findings and Future Directions

Objective evidence of sleep disturbance in women with posttraumatic stress disorder

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