Only a minority of the insomnia sufferers I interviewed for The Savvy Insomniac said their insomnia began in childhood. But regardless of when their sleep problem began, a number reported having had stressful and/or abusive experiences in childhood.
Is there a relationship between adverse childhood experiences and insomnia later in life? Anecdotal and scientific evidence suggests there is.
Liz’s insomnia started in adulthood, worsening around the time of menopause. But she remembered being “a very, very nervous, anxious child”:
I have my suspicions that my trouble sleeping goes back a long, long way. My mother and father had difficulties and they fought a lot, and that made me anxious. I don’t think I feared for myself so much as I felt a general anxiousness about the disruption. Then I had a brother who was 6 years older than me and was always getting into trouble. He grew up with his father away in Egypt during the war. All of sudden he was 6 years old and he had a father and there were major problems between them. That was another disruption, another source of anxiety for me.
Keith thought it was the pattern of abuse he experienced at the hands of a family member that set him up for trouble sleeping:
I experienced severe childhood abuse—physical, emotional, and sexual abuse. It started when I was young and continued a long, long time. It happened early in the morning. When I wake up early now, and I often do, there’s frustration that I’m not able to sleep because I’m vigilant, I’m unable to relax. I’m pretty sure the childhood abuse is the source of my sleep difficulties.
What the Research Shows
Adverse childhood experiences (ACEs) increase people’s susceptibility to health problems later in life. The relationship between ACEs and mental illness, substance abuse, and heart disease is well documented. A recent literature review conducted by Harvard researchers shows that children who experience trauma are also more vulnerable to sleep disorders as adults.
In a majority of studies documenting this relationship, sleep problems were assessed subjectively, by the patients or participants themselves:
- In a retrospective study of data collected from 17,337 HMO members, trouble falling and staying asleep was significantly associated with several types of childhood trauma: (1) physical abuse, (2) sexual abuse, (3) emotional abuse, (4) witnessing domestic violence, (5) household substance abuse, (6) household mental illness, (7)parental separation or divorce, and (8) household member imprisonment.
- In a subsequent study, the authors found these same ACEs to be associated with frequent insufficient sleep.
- In a longitudinal study, children who experienced family conflict between the ages of 7 and 15 were more likely to report insomnia at age 18.
- Among women overall, there was a strong association between childhood sexual abuse and sleep disturbances reported in adulthood.
In two studies, sleep problems were assessed objectively using a wristwatch-type device:
- Among 39 insomnia patients, a history of abuse and neglect explained a moderate amount of variance in sleep onset latency (39%), sleep efficiency (37%), number of body movements (40%) and moving time in bed (36%).
- Among 48 psychiatric outpatients, childhood stress load was a correlate of total sleep time, sleep latency, sleep efficiency, and number of body movements.
Finally, the more traumatic childhood events people reported, the poorer was their quality of sleep:
- People who experienced 1 to 2 ACEs were twice as likely to report poor sleep quality as people with no ACEs. People who experienced 3 to 6 ACEs were 3.5 times as likely to experience poor quality sleep as people with no ACEs.
- As the number of ACEs went up, so did the prevalence of insufficient sleep.
Clearly adverse childhood experiences make it more likely that people will develop chronic insomnia or insomnia symptoms in adulthood. I did not experience familial abuse or neglect. I’m guessing, though, that the bullying I experienced one year at school increased my susceptibility to insomnia . . . but that’s a topic for another blog post.
How about you? Do you think there’s a link between your trouble sleeping and adversity you experienced in your youth?