Gender Differences in Sleep Among Young Adults Who Experienced Childhood Violence

Background

Sleep problems often begin during childhood and can continue throughout the lifespan. Insufficient and poor quality sleep has been associated with a wide range of negative outcomes, including cardiovascular problems, depression, substance use problems, and cancer. Studies have documented the relationship between both direct and indirect experiences of violence and poor sleep. However, despite evidence that cisgender females have more sleep problems than cisgender males, little attention has been paid to the potential role of gender as a link between childhood maltreatment and exposure to domestic violence (CEDV) and sleep disturbance. The current study explored the association between different types of childhood maltreatment, CEDV, and sleep problems among a community sample of low-income young adults, with a particular focus on gender differences.

Methods

Data were collected from 192 young adults (aged 18-24) recruited from a community agency providing support and job training for low-income young adults. All identified as either cisgender male or cisgender female. Valid and reliable measures were used to assess childhood physical abuse, emotional abuse, neglect, child exposure to domestic violence, and sleep. Univariate logistic analyses were used to examine associations between each type of maltreatment and CEDV and sleep disturbance, and the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Multivariate logistic regression was performed to assess the independent associations of maltreatment and CEDV with sleep disturbance after adjusting for potential confounding factors. Interaction terms between gender and childhood maltreatment/CEDV were calculated using the multiplicative model. Finally, if the interaction term was significantly associated with sleep disturbance, stratification analyses were used to test the associations of maltreatment/CEDV with sleep disturbance in males and females.

Results

The overall prevalence of sleep problems in the sample was 57%. In terms of maltreatment, 26% of the sample reported physical abuse, 58% reported emotional abuse, 8% reported sexual abuse, and 36% reported neglect. Forty-one percent of the sample reported CEDV. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=2.22), emotional abuse (aOR=3.15), sexual abuse (aOR=4.16), neglect (aOR=3.04), and CEDV (aOR=4.03). Further stratification analyses by gender showed that females who reported sexual abuse or CEDV had a higher risk of sleep disturbance than males, and males who reported physical abuse had a higher risk of sleep disturbance than females. Males and females who reported any type of abuse or CEDV were more likely to use sleep aids (both prescribed and over the counter) on a regular basis.

Conclusions

A high percentage of the young adults in the sample reported sleep problems. Sustained poor sleep during the transition to adulthood has been linked with long-term problems in education, employment, and building positive social networks. This study suggests that childhood maltreatment and CEDV are risk factors for sleep disturbances. Cisgender males and females may be impacted differently by their experiences of violence. The regular use of sleep aids can also have negative ramifications for health, and in some cases can actually contribute to long-term poorer sleep. Implications for practice, including evidence-based sleep interventions, will be discussed.