Systematic review on the association between sleep-related hyperarousal and child maltreatment

Abstract

Background: Various outcomes like sleep deficiencies can endure into adulthood as consequences from child maltreatment (CM). Hyperarousal as an explanation for the development of insomnia can be applied on this association. However, research on this link is lacking.

Method: A PRISMA-guided systematic literature review was conducted by searching academic literature databases. Empirical studies with no restriction of publishing year were eligible. Search terms were predefined and related to CM.

Results: Of 602 records, 13 studies met the inclusion criteria. Sample sizes ranged from 39 to 304, with a total of 1469 participants. The studies were heterogenous, therefore comparability was diminished. Yet tendencies for sleep-related hyperarousal in maltreated individuals were found especially for somatic hyperarousal. Cortical and cognitive hyperarousal was rarely examined.

Conclusion: Hyperarousal (heightened nighttime acticity and heart rate, diminished heart rate variability) was found in individuals with CM experiences in several studies. The insights into mechanisms of how CM and sleep problems are interrelated, can help to sensitize therapists to not oversee CM experiences when a patient reports sleep difficulties. Yet, more studies with more rigorous methods are needed to illuminate this topic. This gap in research regarding the consequences of CM is not acceptable.

Keywords: Child maltreatment; Cognitive hyperarousal; Cortical hyperarousal; Physiological hyperarousal; Sleep; Somatic hyperarousal.