Intimate partner violence common, raises likelihood of clinical insomnia for midlife women

Nearly two-thirds of midlife women reported a history of intimate partner violence, and that experience was associated with increased odds of clinical insomnia, according to a cross-sectional study published in Menopause.

“Women who experience intimate partner violence are at risk for developing a number of mental health conditions, including PTSD and depression, as well as aging-related physical health conditions, including diabetes, hypertension and urinary tract dysfunction,” Lizbeth A. Goldstein, PhD, assistant professor of psychiatry in the department of psychiatry and behavioral sciences at the University of California, San Francisco, and the San Francisco Veterans Affairs Health Care System, and colleagues wrote. “Sleep difficulty, such as insomnia, is transdiagnostic, either included as a diagnostic criterion of the disorder itself or as a correlate of the physical symptoms of the disorder.”

Researchers extracted cross-sectional data from the Midlife Women Veterans Health Survey and identified 232 women (mean age, 55.9 years; 74% white; 82% postmenopausal) aged 45 to 64 years who were enrolled in Department of Veterans Affairs health care in Northern California. All women completed the Extended-Hurt, Insult, Threaten, Scream (E-HITS) screening tool to assess their lifetime history of intimate partner violence (IPV) and the Insomnia Severity Index to assess current insomnia.

Overall, 63% of women met the criterion for lifetime IPV according to the E-HITS screening tool, with 35% reporting a history of any physical IPV, 27% reporting a history of any sexual IPV and 52% reporting a history of any psychological IPV. In addition, 36% of women reported moderate to severe clinical insomnia.

Having a lifetime history of IPV was associated with a twofold to fourfold odds of current clinical insomnia, including total IPV (OR = 3.24; 95% CI, 1.57-6.69), physical IPV (OR = 2.01; 95% CI, 1.09-3.70), psychological IPV (OR = 3.98; 95% CI, 2.06-7.71) and sexual IPV (OR = 2.09; 95% CI, 1.08-4.07).

According to the researchers, these findings warrant future prospective studies on the development of depressive and PTSD symptoms with insomnia symptoms longitudinally over time due to the evidence of bidirectional associations between mood and symptoms of insomnia.

“Findings highlight the importance of screening midlife women for IPV and recognizing the potential role of this traumatic exposure on women’s health,” the researchers wrote.