The Influence of Childhood IPV Exposure on Adolescent Sleep Quality

Background and Purpose: Nearly half of US women will experience intimate partner violence (IPV) victimization within their lifetime, and it is estimated that approximately 90% of children within families experiencing IPV will have sensory exposure to this violence. Children exposed to IPV have worse sleep health than non-exposed peers, and this may have serious implications for their physical development, mental health, and overall wellness. Prior research has established the contemporaneous link between IPV exposure and sleep health; however, it is not yet known if these associations are lasting, or if there are differential associations by youth sex. Our study investigates the associations of youth exposure to maternal experiences of IPV during early childhood with multiple dimensions of sleep health in adolescence.

Methods: We use five waves of data (at the time of the child’s birth, and at years 1 3, 5, and 15) from the Future of Families and Child Wellbeing Study, a population-based cohort study of nearly 5,000 children born in large US cities between 1998 and 2000. Youth sleep health is operationalized using questions from the BEARS sleep scale that reflects dimensions of sleep health at age 15 based on both youths’ (difficulty falling asleep, difficulty staying asleep, duration of sleep, snoring) and mothers’ reports (excessive daytime sleepiness, bedtime regularity); questions are considered separately and as a standardized average sleep score for analysis. Early childhood IPV exposure is measured from child’s birth to age 5 based on the Conflict Tactics Scale, which measures mothers’ experiences of physical, sexual, controlling, or emotional abuse from her romantic partner. Scores from all waves were averaged and standardized. Analyses are based on a sample of approximately 2,690 adolescents who were interviewed at age 15 and whose mothers’ provided information on their experiences of IPV. Youth biological sex is based on mothers’ report at child’s birth.

We estimate OLS regressions to examine associations of early childhood IPV exposure with sleep health, considering a holistic measure of sleep health and individual sleep dimensions, controlling for a comprehensive set of child, parent, and family characteristics. Next, to explore whether associations between IPV exposure and sleep health vary by sex, we estimate stratified models and perform post-hoc tests of significance between the coefficients.

Results: Among the full sample of youth, we find that higher levels of early childhood IPV exposure are significantly associated with overall worse sleep health scores, and with difficulty falling asleep, difficulty staying asleep, irregular bedtime, and daytime sleepiness. In stratified models, we find substantially stronger associations for female than male adolescents. The association between IPV exposure and poor sleep health remained significant across robustness checks.

Conclusions and Implications: Our results demonstrate that early childhood exposure to maternal experiences of IPV has a strong and lasting impact on sleep health into adolescence, and that female youth may be particularly vulnerable to these negative impacts. These findings have important consequences for understanding and addressing disparities in adolescents’ physical and mental health and can inform social work interventions geared towards youth exposed to IPV.