ArticleFrontiers in psychiatry2026
Perceived sleep disturbance in healthy women with a history of childhood emotional abuse is not reflected in objective sleep measures or nocturnal heart rate variability.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Childhood emotional abuse (CEA) is a prevalent form of childhood maltreatment (CM) and has been consistently linked to psychological distress and sleep disturbances. However, objective sleep measures and heart rate variability often fail to support subjective complaints about sleep. Objective: The aim of this study was to investigate whether healthy women with a history of CEA show more sleep-related hyperarousal and other signs of disturbed sleep compared to women without CEA measured by simple at home devices and questionnaires. Participants and setting: We recruited 65 adult women (mean age 29 years) who reported a history of CEA on the Childhood Trauma Questionnaire (CTQ) and an age-, education- and body mass index matched control group consisting of 64 women without CEA. Methods: Participants completed validated questionnaires assessing depression, pre-sleep arousal, and subjective sleep quality. Objective data on sleep/wake states and nocturnal heart rate variability were collected for one night using a wrist-worn device. Results: The CEA group showed higher depressive symptoms, pre-sleep arousal, and subjective sleep disturbances, while selected objective sleep parameters and HRV did not differ. Within CEA, regression analyses suggested that childhood physical abuse largely accounted for the association between overall childhood maltreatment and insomnia severity, even after controlling analyses of residualization and partial correlations. Conclusions: These findings demonstrate that women with CEA exhibit more depressive symptoms, pre-sleep arousal and subjective sleep complaints that are not fully reflected in objective sleep parameters. The results are in line with previous studies showing discordant results between objective measures and subjective sleep quality in patients with a history of trauma. As physical abuse contributed unique variance to subjective insomnia burden, we temper claims of pure CEA specificity and frame findings in terms of a mixed maltreatment profile. To account for more subtle differences between the two groups, future studies should focus on stage-specific autonomic assessments.
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