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Association between children's exposure to a violent event and objectively and subjectively measured sleep
James C Spilsbury1, Denise C Babineau, Jennifer Frame
1Case School of Medicine, Cleveland, OH, USA.
Insights
Children exposed to violence experience sleep disturbances. Physical assault led to reduced sleep duration and efficiency, while witnessing violence impacted sleep quality, with effects diminishing over time.
Area of Science:
- Pediatric sleep science
- Trauma and child development
- Public health and urban studies
Background:
- Sleep disturbances are frequently reported in children exposed to violence.
- Objective evidence supporting these subjective reports is limited.
- Understanding the impact of violence on child sleep is crucial for intervention.
Purpose of the Study:
- To objectively assess the effects of community or family violence on children's sleep.
- To examine the relationship between violence severity and sleep outcomes.
- To investigate changes in sleep patterns over a 3-month follow-up period.
Main Methods:
- Longitudinal, home-based study design.
- Actigraphy and subjective reports used to measure sleep outcomes.
- Ethnically diverse urban sample of children aged 8-16 years.
Main Results:
- Children physically assaulted showed reduced sleep duration, efficiency, and increased wake after sleep onset.
- Witnessing homicide was associated with increased wake after sleep onset and reported sleep problems.
- Differences in sleep outcomes related to violence exposure generally decreased at 3-month follow-up.
Conclusions:
- Violence exposure significantly impacts children's sleep duration, efficiency, and quality.
- Specific aspects of sleep show varying susceptibility to different types of violence.
- The long-term effects of violence on child sleep require further investigation.
Abstract:
Although sleep disturbances are commonly reported among children exposed to violence, objective evidence of such disturbances is rare. This longitudinal, home-based study assessed the effects of a known community- or family-violence incident on both actigraphy-derived and subjectively reported sleep outcomes of an ethnically mixed, urban sample of children aged 8-16 years. We hypothesized that increased event severity (child physical assault, witnessed homicide) would be associated with lower sleep duration and poorer sleep quality both at baseline and at 3-month follow-up. Covariate-adjusted analyses based on a generalized estimating equations approach showed that children physically assaulted during the event showed lower sleep duration and sleep efficiency and greater wake after sleep onset than those not physically assaulted. Physically assaulted children were more likely to have a later bedtime than non-assaulted children, but this difference decreased at 3 months. Children witnessing a homicide showed greater wake after sleep onset at baseline and reported greater sleep problems than those witnessing a non-homicide event, but these differences decreased at 3 months. They were also somewhat more likely to have greater nightly variation in sleep duration. Collectively, results suggest that violence exposure influences children's sleep, but that specific dimensions of sleep may exhibit different susceptibility to different characteristics of violence, especially over time.