Sleep Disturbance Partially Mediates the Relationship Between Intimate Partner Violence and Physical/Mental Health in Women and Men

Abstract

Intimate partner violence (IPV) is a worldwide health concern and an important risk factor for poor mental/physical health in both women and men. Little is known about whether IPV leads to sleep disturbance. However, sleep problems may be common in the context of IPV and may mediate relationships with mental/physical health. Data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) were used (N = 34,975). IPV was assessed in female and male participants for any history of being threatened by, physically hurt by, or forced to have sex with an intimate partner (THREAT, HURT, and SEX, respectively), and, further, as being forced to have sex with or physically injured by an intimate partner within the past year (SEXyr and HURTyr, respectively). These survey items were coded yes/no. Sleep disturbance was assessed as difficulty falling asleep, staying asleep, or sleeping too much at least 6 of the last 14 days. Logistic regression analyses, adjusted for age, sex, race, income, education, and physical/mental health, assessed whether IPV predicted sleep disturbance. Sobel–Goodman tests assessed whether relationships between IPV and physical/mental health were partially mediated by sleep disturbance. All IPV variables were associated with sleep disturbance, even after adjusting for the effects of age, sex, race/ethnicity, income, education, employment, marital status, physical health and mental health. THREAT was associated with sleep disturbance (odds ratio [OR] = 2.798, p < .0001), as was HURT (OR = 2.683, p < .0001), SEX (OR = 3.237, p < .0001), SEXyr (OR = 7.741, p < .0001), and HURTyr (OR = 7.497, p < .0001). In mediation analyses, all IPV variables were associated with mental health (p < .0001), and all were associated with physical health (p < .007) except SEXyr. Sleep disturbance partially mediated all relationships (Sobel p < .0005 for all tests). Mediation was around 30%, ranging from 18% (HURTyr and mental health) to 41% (HURT and physical health). IPV was strongly associated with current sleep disturbance above the effect of demographics and overall mental/physical health, even if the IPV happened in the past. Furthermore, sleep disturbance partially mediates the relationship between IPV and mental/physical health. Sleep interventions may potentially mitigate negative effects of IPV.

Family violence and mental health in a sample of Finnish health care professionals: the mediating role of perceived sleep quality

“… and Lalley‐Chareczko et al. . However, significant mediation effects were found for only two abuse groups, namely ‘psychological FV only’ and ‘psychological & physical FV’.…”

“… and Lalley‐Chareczko et al. did not distinguish between different forms of FV, and hence it is possible that the mediation effects found in these two studies were also mainly related to psychological abuse.…”

“…A large population‐based study by Lalley‐Chareczko et al. , in turn, concluded that the adverse mental health effects of exposure to physical or sexual violence or threats by an intimate partner were mediated by sleep quality, regardless of whether the violence was measured as life‐time or past‐year prevalence. In contrast, a study by Hernandez‐Ruiz provided somewhat mixed results, concluding that while music therapy effectively reduced anxiety levels and improved the sleep quality of sheltered FV survivors, the changes in these two outcome variables were not correlated.…”

“…In one of the few studies focusing solely on FV, Pigeon et al (35), in a sample of women exposed to FV, found that when adjusted for socio-demographic factors, abuse severity and PTSD symptoms, poor sleep quality significantly increased the risk for depressive symptoms. A large population-based study by Lalley-Chareczko et al (36), in turn, concluded that the adverse mental health effects of exposure to physical or sexual violence or threats by an intimate partner were mediated by sleep quality, regardless of whether the violence was measured as lifetime or past-year prevalence. In contrast, a study by Hernandez-Ruiz (37) provided somewhat mixed results, concluding that while music therapy effectively reduced anxiety levels and improved the sleep quality of sheltered FV survivors, the changes in these two outcome variables were not correlated.…”

Inadequate Sleep as a Mediating Variable Between Exposure to Interparental Violence and Depression Severity in Adolescents

“…Furthermore, a link between violence, sleep, and mental health has previously been established in intimate partner violence (IPV) among adults. Victims of IPV have been shown to be two to three times more likely to report sleep disturbance, and sleep was found to partially mediate the relationship between IPV victimization and mental health (Lalley-Chareczko et al, in press). Finally, there is mounting evidence linking insufficient sleep and depressive symptoms (Lehto & Uusitalo-Malmivaara, 2014; Silva et al, 2011; Sivertsen, Harvey, Lundervold, & Hysing, 2013; Wolfson & Carskadon, 1998) and suicidal ideation and attempts in adolescents (Kang et al, 2014; Lee, Cho, Cho, & Kim, 2012; Liu, 2004).…”