Abstract Introduction Sleep disruption is pervasive among children placed in foster care, elevating risk for a wide range of deleterious outcomes. Unfortunately, even after these children achieve permanency via adoption, sleep problems often persist (Cifre et al., 2024). The extent to which early experiences of abuse and/or neglect prior to placement in foster care may predict problems with sleep even after adoption is unknown. This study examined child experiences of physical abuse, sexual abuse, and neglect as separate predictors of changes in sleep among children adopted from foster care. Methods N=64 adoptive foster parents of a child, ages 6 to 10 years (M=7.9, SD=1.4) completed baseline surveys as a part of a child sleep intervention study. Children were roughly half female (56%) and relatively diverse (19% Black, 23% Hispanic). Parents reported whether their child’s sleep ‘remained the same’, ‘got worse’ or ‘improved’ since the child was first placed in their care. Parents also provided report of adverse childhood experiences (ACEs) including whether the child experienced physical abuse, sexual abuse, or neglect. Results Multinomial logistic regression analyses were conducted. Child reported PROMIS Sleep Disturbance scores were included as a covariate. The experience of neglect significantly predicted worsened sleep after placement in the home, b = 1.744, SE = .809, p = .031. Physical abuse (b = .482, SE = .773, p = .533) and sexual abuse (b = -.981, SE = .847, p = .247) were not significant predictors of worsened sleep, however absence of physical abuse was a marginal predictor of improved sleep after placement in the home, b = -1.226, SE = .716, p = .087. Conclusion Early in life, sleep-wake regulation is facilitated by stable routines, predictable environments, and nurturing interactions with caregivers. Thus, childhood experiences of neglect, even more so than physical harm, may be particularly detrimental for sleep health across development. These findings underscore the enduring importance of parental involvement in sleep during early development and a need for targeted sleep interventions for children with a history of neglect. Support (if any) This study was supported by NIMH grant #R34MH128598 awarded to the last author.
Akepati et al. (Fri,) studied this question.