Abstract Introduction Sleep disturbances are pervasive and impairing among children placed in foster care, commonly underpinned by nighttime fears and anxiety. Fear of Sleep (FoS), which refers to nocturnal fears associated with trauma-related sleep disturbance, has been shown to predict more severe and prolonged sleep disturbance in trauma-exposed adults and represents an important target for intervention. The FoS construct may also be relevant for children exposed to trauma but has not been examined in child samples. In this study we explored the reliability and validity of the FoS construct in a sample of school-aged children with a history of foster care placement. Methods N=68 children adopted from foster care and their parent completed baseline surveys as part of a child sleep intervention study. Children, ages 6 to 10 years, (Mage=7.9, SD=1.4) were roughly half female (56%) and relatively diverse (19% Black, 23% Hispanic). Children completed a modified, age-appropriate version of the Fear of Sleep Inventory (FoSI), the PROMIS Sleep Disturbances scale (PROMIS SD), and the Pre-Sleep Arousal Scale for Children (PSAS-C), and parents completed the Children’s Sleep Habits Questionnaire (CSHQ). Results The 23-item FoSI demonstrated good internal consistency (Cronbach’s α = .84). Convergent validity was also found based on moderate to strong associations with related measures including both cognitive and somatic pre-sleep arousal (PSAS-C: r =.62 and r = .59, respectively) and overall sleep disturbance severity (PROMIS SD: r = .43). The FoSI also demonstrated small to moderate associations with parent-reported CSHQ bedtime resistance (r = .32) and sleep anxiety (r = .32). Conclusion In our small sample of trauma-exposed children, the modified FoSI demonstrated internal consistency and convergent validity, suggesting promise as a measure of nocturnal fears that could inform intervention delivery. Future studies are needed to examine the utility of the FoSI in other trauma-exposed child samples. Support (if any) This research was supported by an NIMH grant (R34MH128598) awarded to C. Alfano.
Mack et al. (2026) studied this question.