Universität Bielefeld, Germany.
Universitätsklinikum Ulm, Germany.
Sleep Med. 2021 Aug;84:219-226. doi: 10.1016/j.sleep.2021.05.041. Epub 2021 Jun 6.
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.
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.
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.
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.
儿童虐待(CM)会导致各种后果,包括睡眠不足,并延续到成年期。过度觉醒可以解释失眠的发展,这可以应用于这种关联。然而,关于这种联系的研究还很缺乏。
通过搜索学术文献数据库,进行了 PRISMA 指导的系统文献综述。没有出版年限限制的实证研究符合纳入标准。搜索术语是预先定义的,并与 CM 相关。
在 602 条记录中,有 13 项研究符合纳入标准。样本量从 39 到 304 不等,共有 1469 名参与者。这些研究具有异质性,因此可比性降低。然而,在遭受虐待的个体中发现了与睡眠相关的过度觉醒的趋势,尤其是躯体过度觉醒。皮质和认知过度觉醒很少被检查。
几项研究发现,有 CM 经历的个体存在过度觉醒(夜间活动和心率增加,心率变异性降低)。深入了解 CM 和睡眠问题如何相互关联的机制,可以帮助治疗师在患者报告睡眠困难时不忽视 CM 经历。然而,需要更多方法更严谨的研究来阐明这个问题。在 CM 的后果方面,这种研究差距是不可接受的。