Childhood sexual violence is associated with increased odds of various types of sleep disturbances in adulthood, particularly among victims of rape.
Key Findings
Results
Approximately 13% of participants reported experiencing some form of childhood sexual violence, with notably higher prevalence in women.
The analytic sample comprised 114,373 adults with a mean age of 52.2 years from the 2020 wave of the CONSTANCES cohort, a nationwide French population-based study.
Childhood sexual violence was categorized as: no exposure, non-penetrative childhood sexual violence, or rape (with or without other forms of sexual violence).
The overall prevalence of childhood sexual violence was 13% across the sample.
Prevalence was described as 'notably higher in women' compared to men.
Results
The prevalence of sleep disturbances in the study sample was 11.4% for frequent nocturnal awakenings, 10.4% for short sleep duration, and 6.3% for late chronotype.
Frequent nocturnal awakenings were defined as waking 3 or more times per night.
Short sleep duration was defined as less than 6 hours.
Late chronotype was defined as MSFsc (mid-sleep on free days, sleep-corrected) greater than 5:00.
These prevalences were measured across the full analytic sample of 114,373 adults.
Results
Rape was consistently associated with higher odds of frequent nocturnal awakenings in both women and men.
Among women, rape was associated with an adjusted odds ratio of 1.35 (95% CI: 1.22–1.50) for frequent nocturnal awakenings.
Among men, the association was stronger, with an adjusted odds ratio of 1.73 (95% CI: 1.37–2.15).
Sex-stratified adjusted logistic regression models were used, controlling for potential confounders.
Non-penetrative childhood sexual violence (other sexual violence excluding rape) showed more modest associations with this outcome.
Results
Rape in childhood was associated with significantly higher odds of short sleep duration in adulthood for both sexes.
Among women, rape was associated with an adjusted odds ratio of 1.37 (95% CI: 1.23–1.54) for short sleep duration.
Among men, the adjusted odds ratio was 1.61 (95% CI: 1.27–2.04) for short sleep duration.
Short sleep duration was defined as less than 6 hours per night.
Associations for non-penetrative sexual violence were described as more modest compared to rape.
Results
Rape in childhood was associated with significantly higher odds of late chronotype in adulthood, with stronger associations observed in men than women.
Among women, rape was associated with an adjusted odds ratio of 1.58 (95% CI: 1.38–1.82) for late MSFsc.
Among men, the association was notably stronger with an adjusted odds ratio of 2.08 (95% CI: 1.62–2.67) for late MSFsc.
Late chronotype was defined as MSFsc greater than 5:00.
Multinomial logistic regression models were used for sleep duration and chronotype outcomes.
These associations remained significant after adjustment in sex-stratified models.
Results
Childhood sexual violence was significantly associated with all sleep outcomes examined, including nocturnal awakenings, sleep duration, and chronotype.
Associations were estimated using sex-stratified adjusted logistic and multinomial logistic regression models and reported as adjusted odds ratios with 95% confidence intervals.
Both forms of childhood sexual violence (non-penetrative and rape) showed significant associations, though rape showed consistently stronger associations across all outcomes.
The study examined three distinct sleep dimensions simultaneously: sleep continuity (nocturnal awakenings), sleep duration, and circadian preference (chronotype).
The large sample size (114,373 adults) allowed for precise estimation of associations and sex-stratified analyses.
What This Means
This research suggests that experiencing sexual violence during childhood is linked to a range of sleep problems in adulthood. Using data from over 114,000 French adults, researchers found that about 13% of participants reported some form of childhood sexual violence, with higher rates among women. Those who experienced childhood sexual violence were more likely to wake up frequently during the night, sleep fewer than 6 hours, and have a late chronotype (being a 'night owl'). These associations held even after accounting for other factors that might influence sleep.
The study found that rape in childhood was more strongly linked to sleep problems than non-penetrative forms of sexual violence. For example, men who experienced childhood rape were about twice as likely to have a late chronotype compared to those with no such history. While associations were present in both men and women, some effects appeared stronger in men, possibly because fewer men reported such experiences, or because social stigma affects how men report and cope with these events.
This research suggests that the effects of childhood sexual violence can persist decades into adulthood, affecting not just mental health but also basic biological functions like sleep and circadian rhythms. The findings highlight the importance of asking about childhood trauma history when assessing sleep problems in adults, and may point toward a need for trauma-informed approaches in the treatment of sleep disturbances.
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Al Zayat T, Van Der Waerden J, Bailhache M, Wiernik E, Zins M, Melchior M, et al.. (2026). Childhood sexual violence and sleep disturbances in adulthood: Findings from a large French population-based study (CONSTANCES).. Sleep health. https://doi.org/10.1016/j.sleh.2026.03.005