0954 Domestic Violence as a Risk Factor for Insomnia and Short Sleep Duration, and the Role of Depressed Mood and Anxiety Symptoms

Abstract

Introduction: This study examined domestic violence as a risk factor for insomnia and the role of anxiety and depressed mood. Method(s): Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) Study, consisting of N=1007 adults age 22-60. Domestic violence was assessed with the HITS scale, which consists of 4 items, asking how often a partner "physically hurt you" (physical), "insult or talk down to you" (verbal), "threaten you with harm" (threaten), or "scream or curse at you" (scream). Insomnia was assessed with the insomnia severity index. Sleep duration was assessed as typical weekday sleep. Depressed mood and anhedonia were measured with items from the PHQ9. Anxiety was assessed with the GAD7. Feeling unsafe at night was assessed. Additional covariates included age, sex, race/ethnicity, and education. Forward stepwise regression evaluated unique contributors of variance in HITS score. Sobel test evaluated insomnia as a partial mediator between HITS and GAD7 scores. Result(s): N=816 adults reported a partner and were administered the HITS scale. Both insomnia and sleep duration were associated with all 4 domestic violence items and total score. After adjusting for covariates, demographics, mood, and feeling unsafe, domestic violence exposure predicted insomnia (Physical B=1.09,95%CI[0.30,1.87],p=0.007; Verbal B=0.50,95%CI[0.07,0.93],p=0.02; Threaten B=1.07,95%CI[0 .37,1.78],p=0.003; Scream B=0.57,95%CI[0.14,1.00],p=0.01; Total B=0.27,95%CI[0.10,0.44],p=0.002). When anxiety was added to the model, these were all non-significant. For sleep duration, relationships were non-significant when insomnia was included in the model. Stepwise analysis showed that unique contributors of variance to domestic violence score were, in order, anxiety (B=0.11,p<0.0001), safety (B=0.19,p<0.0001), sex(B=-0.57,p<0001), and insomnia (B=0.03,p=0.018). In mediation analysis, the relationship between domestic violence and anxiety was partially mediated by insomnia (35.4%, Sobel p <0.0001). Conclusion(s): Sleep should be assessed in those who suffer domestic violence. Although this is partially explained by anxiety, it is possible that intervening in insomnia may mitigate some of the adverse outcomes associated with domestic violence.