Original ArticleChildhood adversities and quality of sleep in adulthood: A population-based study of 26,000 Finns
Introduction
Childhood circumstances show longitudinal associations with variation in a broad range of health outcomes [1]. A strong graded association has been reported between adverse childhood experiences and multiple risk factors including health behaviours for several of the leading causes of death and disability retirement in adults [2], [3]. In addition, recent evidence suggests that vulnerability to depression is affected by negative experiences during childhood and relationship with the parents [4], [5]. Thus, childhood exposures seem to operate behind many health and lifestyle factors in adulthood.
Sleep disturbances, such as chronic insomnia, are common problems in populations of Western industrialised countries. Ten to 35% suffer from insomnia symptoms [6], [7]. It has been estimated that in the general population insomnia is as common a condition as depression, but while depressive disorders have become well recognised public health problems with targeting interventions, insomnia and other sleeping problems are relatively ignored [8].
Sleep disturbances have been shown to be associated with many health risks and medical conditions, such as high alcohol intake, depression, work status and stressful life events [7], [9], [10]. Exposure to highly traumatic events, such as physical assault and death of a close family member, has especially been hypothesized to precipitate the onset of sleep disturbances [11], [12], [13]. But more research is needed on the complex associations between different factors during the life course in the development of chronic sleep disturbances.
Bader et al.’s study with non-treated adults suffering from primary insomnia indicated that adverse experiences in childhood seem to be associated with sleep in adults [14]. Insomniacs with many adverse childhood experiences exhibited more movement arousals, a greater number of awakenings, more disturbed sleep and increased nocturnal activity. Also family conflict predicted insomnia in adolescence [15]. Nevertheless, we lack population-based studies on the association between childhood adversities and sleep among adults.
In this study, we investigated whether childhood adversities are associated with the quality of sleep among 26,000 working aged Finns. We hypothesized a dose–response association between the number of childhood adversities and quality of sleep as an adult and when adjusted for a number of confounding or modifying factors.
Section snippets
Data and study variables
Data were derived from the Health and Social Support (HeSSup) follow-up study on a sample of the Finnish population. The baseline survey was carried out by postal questionnaire during 1998 (N = 25,898, age groups: 20–24, 30–34, 40–44, 50–54, response rate 40.0%), and a follow-up questionnaire (response rate 80.2%) was sent during the end of 2003 through the beginning of 2004 to all those who responded to the first questionnaire. The study sample of this study consisted of all respondents from the
Results
Poor quality of sleep was reported by 14% of the participants (11% quite poor, 3% poor), 40% had experienced no childhood adversity, 42% reported 1–2 adversities and 19% 3–6 adversities. Older age, work status, recent life events and use of psychotropic drugs were associated with poor quality of sleep. Those with poor quality of sleep more often reported childhood adversities and poor child–parent relationships. In addition, health related risk behaviour, such as heavy alcohol consumption,
Discussion
Population-based studies on the life course determinants of sleep problems, including events from childhood to adulthood, are considerably lacking. The aim of the present study was to examine whether childhood adversities are associated with the quality of sleep among working aged Finns. Poor quality of sleep was four times more common among those with multiple childhood adversities and quite poor quality was three times more common. The dose–response association remained after adjustments for
Conclusions
This study showed a clear dose–response association between childhood adversities and the quality of sleep in adulthood, which remained significant after adjustments for known risk factors for sleep disturbances. Risk of poor quality of sleep was especially increased among those who had experienced frequent fear of a family member and serious conflicts in their childhood family. In addition, the combination of poor child–parent relationship and multiple adverse experiences showed strong effect
Conflict of interest
None declared.
Acknowledgment
The postal surveys in 1998 and 2003 were funded by the Academy of Finland.
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