Relationship between early-life stress load and sleep in psychiatric outpatients: a sleep diary and actigraphy study

The present study aimed to investigate whether stress experienced early in life is associated with actigraphic and subjective sleep measures in a sample of adult psychiatric outpatients. A total of 48 psychiatric outpatients completed self-report questionnaires assessing current depression, current anxiety symptoms and stress load during childhood (before the age of 13 years), adolescence (between the age of 13 and 18 years) and adulthood (between the age of 19 and current age). Sleep-related activity was measured using 24-h wrist actigraphy over a 7-day period at home, during which participants also kept a sleep diary. High stress load in childhood, but not in adolescence, was associated with shortened actigraphically assessed total sleep time, prolonged sleep onset latency, decreased sleep efficiency and an increased number of body movements in sleep, even after accounting for the effects of later occurring stress and psychopathological symptoms such as depression and anxiety scores. Unexpectedly, no significant associations between early-life stress load and subjective sleep measures were found. Results are consistent with findings from previous studies indicating an association between childhood adversities and higher levels of nocturnal activity. The findings suggest that high stress load during childhood might be a vulnerability factor for sleep continuity problems in adulthood.