The finding of elevated risk among respondents who reported frequent experiences of child abuse is consistent with previous theorizing on the especially deleterious effects of chronic stress. Scholars have posited that although humans’ stress response system is well suited to handle acute stressors, chronic activation of the stress response system is especially likely to result in poor health outcomes [44]. Focusing specifically on frequent abuse, scholars have posited that abuse which occurs regularly over long periods of time is likely to profoundly damage healthy development by creating cumulative problems across various developmental stages [45].
In addition to respondents who reported frequent experiences of physical and emotional abuse, respondents who reported occasional physical and emotional abuse—in combination with sexual abuse—also were found to be at elevated risk for global sleep pathology. This class of abuse was also associated with several, but not all, individual sleep components, including latency and daytime dysfunction. These findings point to the long-term potency of sexual abuse on adult sleep quality in the context of less frequent experiences of other types of abuse. Perhaps because sexual abuse often occurs in bedrooms or at night, adults with histories of sexual abuse even with relatively rare experiences of other types of abuse might have developed long-lasting psychological associations between sleep and fear [46]. This might account for the heightened risk of global sleep pathology among adults who experienced physical and emotional abuse less frequently, but who also experienced sexual abuse.