Childhood maltreatment and 20-year trajectories of sleep disturbance among midlife women: the Study of Women's Health Across the Nation.

Childhood maltreatment and adult sleep disturbance are significant, related public health concerns, but the extent to which they are associated over time is unknown. We investigated whether childhood maltreatment is associated with sleep disturbance over 20 years in a large, diverse, community sample of 1654 midlife women from 1996 to 2017 in a multicenter cohort study: The Study of Women's Health Across the Nation. Childhood maltreatment was assessed via The Childhood Trauma Questionnaire, and insomnia symptoms were assessed via self-report at 14 visits. Insomnia symptom trajectories were derived using group-based trajectory modeling. Associations between childhood maltreatment and insomnia trajectories were evaluated via multinomial logistic regression. Four trajectories of insomnia symptoms were identified: consistently low, increasing, moderate/decreasing, and consistently high symptoms. Childhood maltreatment was associated with higher adjusted odds of moderate/decreasing (odds ratio [OR], 1.40; 95% CI, 1.05-1.87) and consistently high (OR, 2.06; 95% CI, 1.56-2.74) insomnia symptoms, respectively. Both physical and sexual abuse were associated with higher adjusted odds of moderate/decreasing and consistently high insomnia symptoms. Childhood maltreatment, particularly physical and sexual abuse, is associated with higher odds of chronic insomnia symptoms in women across midlife. These findings point to an at-risk population that may warrant early intervention to prevent and reduce disturbed sleep.