Relationship Between Early‐life Stress Load and Sleep in Psychiatric Outpatients: A Sleep Diary and Actigraphy Study

Abstract

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.

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

“…This is consistent with the prior report of Schafer and Bader (2013), who found that actigraph-assessed sleep in adult outpatients was affected by stress load prior to age 13, but not associated with stress during adolescence or adulthood. Parental NVEA emerged as a discrete form of emotional abuse during construction of the MACE (Teicher & Parigger, 2015).…”

“…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.…”

Adverse childhood experiences are associated with adult sleep disorders: a systematic review

“…We found two studies that assessed sleep outcomes in men and women using objective methods [37, 38]. In their study of 63 military veterans, Insana et al [37] reported that early life trauma, assessed using the Trauma History Questionnaire (THQ), was not statistically significantly correlated with rapid eye movement (REM) latency, % REM, number of REM periods, or REM microarousals measured via polysomnography (PSG).…”

“…The only sleep outcome found to be correlated with veterans’ history of child trauma was REM fragmentation (r = 0.36, p = 0.005). Schafer et al [38] compared stress load in early life with both subjective and 7-day actigraphic measures of sleep. The authors found that childhood stress load was a correlate of objectively measured total sleep time (β = −0.32, p ≤ 0.05), sleep latency (β = 0.32, p ≤ 0.05), sleep efficiency (β = −0.32, p ≤ 0.05), and number of body movements (β = 0.27, p < 0.10) [38].…”

Sleep and Behavior in Cross-Fostering Rats: Developmental and Sex Aspects

“…4,38 Most human studies on the effects of adverse childhood experiences on sleep have been obtained from self-reported and/or actigraphy data, and do not contain polysomnographic studies.…”