Childhood sexual violence and sleep disturbances in adulthood: Findings from a large French population-based study (CONSTANCES)

OBJECTIVES: Although childhood sexual violence has been linked to sleep disturbances, but population-based evidence examining multiple sleep dimensions and differentiating types of sexual violence remains limited. We examined associations between childhood sexual violence and adult sleep outcomes in a large French cohort. METHODS: We used data from the 2020 wave of the CONSTANCES cohort, a nationwide population-based study. The analytic sample comprised 114,373 adults (mean age = 52.2) with information on childhood sexual violence, categorized as no exposure, non-penetrative childhood sexual violence, or rape (with or without other forms of sexual violence). Sleep outcomes included frequent nocturnal awakenings (≥3 times/night), sleep duration (short, normal, or long), and chronotype (early, intermediate, or late). Associations were estimated using sex-stratified adjusted logistic and multinomial logistic regression models, and are reported as adjusted odds ratios (ORa) with 95% confidence intervals. RESULTS: Overall, 13% of participants reported experiencing some form of childhood sexual violence. This prevalence was notably higher in women. The prevalence of sleep disturbances was 11.4% for frequent nocturnal awakenings, 10.4% for short sleep duration (<6 hours), and 6.3% for late chronotype (MSFsc >5:00). Childhood sexual violence was significantly associated with all sleep outcomes. In adjusted models, rape was consistently associated with higher odds of sleep disturbances, including frequent nocturnal awakenings (women: ORa = 1.35(1.22-1.50); men: ORa = 1.73(1.37-2.15)), short sleep duration (women: ORa = 1.37(1.23-1.54); men: ORa = 1.61(1.27-2.04)), and late MSFsc (women: ORa = 1.58(1.38-1.82); men: ORa = 2.08(1.62-2.67)). Other sexual violence excluding rape showed more modest associations. CONCLUSIONS: Childhood sexual violence is associated with increased odds of various types of sleep disturbances in adulthood, particularly among victims of rape.