Sleep disturbances following traumatic experiences in childhood and adolescence: A review

The present review article discusses the long-term effects of traumatic and stressful events in childhood - a research area that has attained growing interest in the last decade. The results of several longterm studies, some of them largescale, indicate that early physical and psychosocial stressors can lead to an increased vulnerability to physical and mental diseases in adult age. Sleep and dreaming seem to be affected as well. Several studies yield evidence that physical and emotional abuse, neglect, familial violence and conflicts, injuries, accidents, war and disasters experienced during childhood are associated with sleep disturbances. Difficulties initiating and maintaining sleep, non-restorative sleep and an elevated frequency of night terror, anxiety dreams and nightmares are among the most commonly reported problems. Polysomnographic and actigraphic recordings show reduced sleep efficiency, more frequent and prolonged night awakenings and increased body movement during sleep in individuals who report traumatic experiences. Sleep disturbances can be an immediate effect of traumatic childhood experiences, but can also persist for years after a stressful event. The search for an empirically founded theory explaining the relations between traumatic childhood experiences and sleep is not yet concluded. Chronic hyperarousal and hypervigilance, maladaptive sleep behaviours, secondary anxiety conditioning processes as well as disturbances of trauma processing and memory functions during sleep are hypothesized to be factors involved. © 2007 Steinkopff-Verlag.