Exploring Sleep Quality and Childhood Welfare Experiences in Aging Group Care Alumni

Background and Purpose: Transitioning out of foster care into adulthood presents numerous challenges for alumni but little is known about how their challenges evolve across their lifespan. Among the under-explored areas is examining sleep quality and its impact on well-being in an aging foster care alumni Given the associations between childhood trauma and sleep and the well-documented pivotal role of sleep-in overall health and functioning in the general population, it is critical to examine sleep and its associations in foster care alumni.

Objective: To fill part of this gap, our exploratory mixed-method study investigates the sleep quality of North American group care leavers aged 30 and older, aiming to discern if adult sleep quality predicts childhood welfare experiences or social support networks across the lifespan. Additionally, we explore the association between health status, sleep quality, and social support networks.

Methods: We employed a convenience sample of 41 alumni aged 30-85. The study involved a diverse group of participants with varied characteristics. Regarding gender, 16 identified as male, 23 as female, and 2 as non-binary or third gender. Regarding racial identities, 30 identified as White, 10 identified as racialized or Indigenous. Our survey findings were further supplemented by 16 qualitative narrative interviews, which we used to explore the intricate connections among group care leavers' developmental trauma, sleep quality, and health. Our analysis integrates linear regression and qualitative content analysis of narrative interviews, to elucidate how sleep patterns relate to well-being among aging group care alumni.

Results: Our findings reveal a significant positive association between adult sleep quality and the perceived quality of childhood protection experiences (β = 0.421, p < 0.01) while controlling for friendship support networks and demographic variables. Furthermore, an additional regression model underscores the predictive power of sleep quality on overall health (β = -.328, < 0.05) even after controlling for social support, income, ethnicity, and race. Qualitative interviews further illuminate the significance and interconnections of sleep, childhood welfare experiences, and well-being.

Conclusions and Implications: This research underscores the enduring impact of adverse childhood welfare experiences on sleep patterns, and it documents that sleep challenges can persist across the life course. Moreover, our findings underscore the link between sleep patterns and health outcomes, even when considering contemporaneous social support networks, age, and other demographic factors. These insights have both clinical and research implications. For clinicians, this research suggests that targeted interventions to screen and address sleep challenges, both for youth in care and for those who have experienced placement, could be important. For researchers, these findings suggest that examining sleep in larger samples and expanding panel studies beyond the emerging adulthood period is likely to lead to important developmental findings.