Sleep Patterns And Biomarkers Of Stress Among Women With A History Of Sexual Abuse In Childhood



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Childhood sexual trauma (CSA) is associated with persistent deleterious health outcomes into adulthood, including mental health symptoms and sleep disturbance. It is thought that early exposure to CSA leads to nighttime hyperarousal and dysregulation in various biobehavioral systems, producing persistent problems with sleep-wake regulation. However, despite numerous longitudinal studies documenting robust relationships between CSA and poor sleep health in adulthood, studies utilizing objective sleep measures, examining specific aspects of CSA and investigating mechanisms that explain long-term sleep problems are highly limited. The purpose of the present study was to examine correlates of and putative mediators and moderators that account for associations between posttraumatic stress symptoms (PTSS) and sleep disturbance women with a history of CSA. N = 64 cis-gendered women with a self-reported history of CSA completed a baseline diagnostic interview, self-reported mental health and sleep measures, seven days of actigraphy monitoring with concurrent sleep diary, and two days of saliva sampling. After controlling for comorbid mental health problems and intermediary traumas, overall CSA severity was significantly negatively associated with actigraphy-derived wake minutes after sleep onset, but not total sleep time or sleep onset latency. CSA was also negatively associated with sleep diary-recorded sleep quality. In terms of putative mediators and moderators, pre-sleep arousal, particularly cognitive pre-sleep arousal, partially mediated the relationship between PTSS and subjective sleep quality. However, specific features of CSA (e.g., age at time of abuse, location of abuse, relationship to the perpetrator) did not moderate this effect. These findings suggest that, irrespective of specific characteristics of childhood abuse, CSA robustly forecasts mental health problems and both objective and subjective sleep disturbance in adulthood. Further, findings suggest that psychological treatments should prioritize reducing maladaptive thoughts, worries, rumination, and other cognitive activity during the pre-sleep period as a specific intervention targets.



Childhood sexual abuse, Sleep, PTSD, Anxiety, Women, Cortisol, Stress