Trauma-associated sleep disturbances among women in a nationwide study

BACKGROUND: Trauma-associated sleep disorder is a proposed sleep disorder characterized by trauma-related nightmares, hyperarousal during sleep, and disruptive nocturnal behaviors following exposure to a traumatic event. Sleep problems are common after trauma, yet little is known about their prevalence among women in the general population. We aimed to estimate the prevalence of trauma-associated sleep disturbances (TASD) and identify associated factors in a large nationally representative cohort. METHODS: We used data from a population-based cohort of Icelandic women aged 18 to 69 years. Of the 30,403 women who provided informed consent, 27,938 women were included in the analysis. Participants completed assessments of trauma history, TASD, and other mental health outcomes. Past month TASD were identified using established symptom criteria. Prevalence ratios were estimated using modified Poisson regression adjusted for demographic, socioeconomic, behavioral, and trauma-related factors. RESULTS: Here we show that 6.9% of women in the cohort report TASD. Prevalence was highest among young women and those exposed to physical or sexual violence. Experiencing the worst life stressor more than once and close temporal proximity to the worst life stressor was also associated with higher TASD prevalence. TASD are strongly associated with symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and general sleep problems. CONCLUSIONS: Results indicate that TASD affect a substantial number of women in the general population and are most prevalent among women exposed to interpersonal violence and among those with repeated or recent traumatic experiences. These findings underscore the importance of early identification of TASD and targeted interventions in healthcare.