Does sleep disruption mediate the effects of childhood maltreatment on brain structure?

Abstract

Background: Childhood maltreatment is associated with alterations in morphology of stress susceptible brain regions. Maltreatment is also known to markedly increase risk for psychopathology and to have an enduring disruptive effect on sleep. Objective: To determine whether abnormalities in sleep continuity have effects on brain morphometry and to evaluate the extent to which sleep impairments mediate the effects of maltreatment on brain structure. Method: Maltreatment and Abuse Chronology of Exposure (MACE) scale ratings, actigraph-assessed sleep and 3T MRI were obtained on N = 37 18–19-year-old participants recruited from the community (N = 34 with neuroimaging). Results: Fourteen participants had no history of maltreatment while N = 23 were exposed, on average, to 4.7 types of maltreatment. Multiplicity of maltreatment was strongly associated with reduced sleep efficiency, increased wake after sleep onset time and number/duration of awakenings, which were independent of effects of maltreatment on depression and anxiety. The most important predictors of impaired sleep were exposure to parental non-verbal emotional abuse at 9–10 years of age. Reduced sleep efficiency correlated with reduced grey matter volume in hippocampus including CA1 subfield, molecular layer and dentate gyrus as well as inferior frontal gyrus and insula. Sleep mediated 39–46% of the effects of maltreatment on volume of hippocampal structures and inferior frontal gyrus. Conclusions: Actigraph-assessed sleep is disrupted in maltreated late teens and mediates a significant portion of the effects of maltreatment on hippocampal volume. Studies are needed to assess whether efforts to enhance sleep in maltreated children can pre-empt or ameliorate neurobiological consequences of maltreatment.

Child maltreatment across the lifespan

“…Teicher et al (2018) investigated whether abnormalities in sleep continuity have effects on brain morphometry and whether sleep impairments mediate the effects of child maltreatment on the brain structure in the late teens. Child maltreatment was found to be significantly associated with several different indicators of disruptive effects on sleep, and exposure to parental non-verbal emotional abuse was the most important predictor of impaired sleep.…”

Irregular sleep habits, regional grey matter volumes, and psychological functioning in adolescents

“…These studies support the theory that unhealthy sleep habits could affect the developing adolescent brain structure and thereby increase the vulnerability to various kinds of psychopathologies, but few studies on the relationship between adolescents' sleep habits and brain grey matter volumes have been published to date. In a sample of maltreated teenagers, reduced sleep efficiency was recently found to correlate with reduced grey matter volume (GMV) in hippocampus, inferior frontal gyrus and insula, suggesting that sleep might mediate the negative impact of adverse life events on brain morphology [6]. In a mixed sample of children and adolescents, weekday time in bed was found to correlate with regional grey matter volumes of the bilateral hippocampi and the dorsolateral prefrontal cortex [7].…”

Measuring childhood maltreatment: Psychometric properties of the Norwegian version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale

“…Moreover, MACE has been indicated to account for substantially more of the variance in psychiatric symptom ratings compared to the CTQ and ACE [15]. US and German versions of the instrument have already been successfully employed in studies of psychiatric symptoms and a variety of other sequels of adverse childhood experiences, including sleep disruption, stress sensitivity and resilience, and altered brain functioning and structure [18][19][20][21][22][23].…”