Background

A history of childhood maltreatment has a well-established association with clinical sleep disturbances in adulthood, which is a transdiagnostic contributor to many chronic diseases.

Objective

Determine whether actigraphy-measured indices of dysregulated arousal during sleep explain associations between abuse or neglect in childhood and clinical sleep disturbances in adulthood.

Participants and setting

Participants were 646 individuals, ages 25–83 (59.3% female) from the MIDUS II Biomarker, Refresher studies.

Methods

Participants completed the Childhood Trauma Questionnaire, wore an actigraph for seven days, and rated sleep quality using the Pittsburgh Sleep Quality Index (PSQI).

Results

Both neglect (b = 0.66, SE = 0.33, p = .04) and abuse (b = 1.09, SE = 0.32, p < .001) were associated with clinical sleep disturbance. Actigraphy-measured sleep efficiency mediated the link between neglect and clinical sleep disturbances (ab = 0.33, SE = 0.12, 95%CI [0.12, 0.57]). However, no such link between abuse and clinical sleep disturbances was mediated by actigraphy-measured indices. Sleep onset latency did not mediate the link between neglect or abuse and sleep disturbance. Models covaried for other maltreatment, gender, and age.

Conclusions

While the unique associations between abuse or neglect and clinical sleep disturbances were robust in this sample, only sleep efficiency emerged as a mediator linking maltreatment and clinical sleep disturbances. Critically, this mediation was specific to neglect. Abuse and neglect may lead to disease through distinct pathways. Moreover, potential dysregulation in arousal that leads to sleep inefficiency may be a specific pathway through which experiences of neglect in childhood contribute to chronic disease.

中文翻译：

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唤醒失调是连接儿童忽视和成年期临床睡眠障碍的途径

背景

童年虐待史与成年期临床睡眠障碍有着明确的关联，这是许多慢性疾病的跨诊断因素。

客观的

确定在睡眠期间运动记录测量的异常觉醒指数是否解释了儿童期虐待或忽视与成年期临床睡眠障碍之间的关联。

参与者和设置

参与者是来自 MIDUS II 生物标志物进修研究的 646 名个体，年龄在 25-83 岁之间（59.3% 为女性）。

方法

参与者完成儿童创伤问卷，佩戴活动记录仪 7 天，并使用匹兹堡睡眠质量指数 (PSQI) 对睡眠质量进行评分。

结果

忽视 ( b  = 0.66, SE  = 0.33, p  = .04) 和虐待 ( b  = 1.09, SE  = 0.32, p  < .001) 都与临床睡眠障碍有关。活动图测量的睡眠效率介导了忽视和临床睡眠障碍之间的联系（ab  = 0.33，SE  = 0.12，95 %CI [0.12，0.57]）。然而，滥用和临床睡眠障碍之间没有这种联系是由活动记录测量指数介导的。入睡潜伏期并未调节忽视或虐待与睡眠障碍之间的联系。模型针对其他虐待、性别和年龄进行了协变。

结论

虽然虐待或忽视与临床睡眠障碍之间的独特关联在该样本中是强有力的，但只有睡眠效率成为将虐待与临床睡眠障碍联系起来的中介。至关重要的是，这种调解是专门针对忽视的。虐待和忽视可能通过不同的途径导致疾病。此外，导致睡眠效率低下的潜在唤醒失调可能是儿童忽视经历导致慢性疾病的特定途径。