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World J Psychiatr. Feb 19, 2021; 11(2): 27-34
Published online Feb 19, 2021. doi: 10.5498/wjp.v11.i2.27
Sleep problems in children and adolescents following traumatic life events
George Giannakopoulos, Gerasimos Kolaitis
George Giannakopoulos, Gerasimos Kolaitis, Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
Author contributions: Kolaitis G conceived the original idea; Giannakopoulos G and Kolaitis G wrote the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: George Giannakopoulos, MD, PhD, Assistant Professor, Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Thivon & Papadiamantopoulou, Athens 11527, Greece. ggiannak@med.uoa.gr
Received: November 30, 2020
Peer-review started: November 30, 2020
First decision: December 21, 2020
Revised: December 21, 2020
Accepted: December 28, 2020
Article in press: December 28, 2020
Published online: February 19, 2021
Abstract

Rates of childhood trauma exposure are extremely high, with approximately 70% of children and adolescents experiencing at least one traumatic event. Among the most common non-specific consequences of stress and trauma are disruptions of sleep. Sleep problems, such as shorter sleep duration, difficulty falling asleep, frequent awakenings, nightmares, sleepless nights, and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events. This review will illustrate the role of sleep problems in traumatized children and adolescents, and emphasize the need to consider a wide range of etiological mechanisms for these symptoms. However, the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research. Moreover, in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma, the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.

Keywords: Child abuse, Natural disasters, Nightmares, Posttraumatic stress disorder, Sleep, Trauma and stressor related disorders

Core Tip: Prevalence rates of child and adolescent posttraumatic stress disorder (PTSD) range from 0.5%-5%, while subthreshold PTSD and other trauma-related difficulties are relatively common among trauma-exposed children. Prevalence rates of sleep disturbances among trauma-exposed child samples vary considerably. Adverse effects of childhood trauma on sleep have been found immediately as well as years after trauma and can still be demonstrated in adulthood. Several hypotheses have been proposed to explain the mechanisms by which traumatic exposure may affect sleep. We discuss here the role of sleep problems in traumatized children and adolescents, and a broad range of etiological mechanisms for these symptoms.