Sleep isn’t just rest. For a child, it’s regulation. It’s repair. It’s the brain’s nightly reboot and the nervous system’s quiet recovery.
In children impacted by trauma, sleep is often the first thing to break and the last to mend.
Children exposed to domestic violence, abuse, neglect, or displacement are frequently stuck in survival mode. Even long after the threat has passed, their nervous systems remain on high alert, pumping stress hormones like adrenaline and cortisol through their bodies. In this state, sleep becomes biologically difficult. It’s not a matter of routine. It’s a matter of wiring.
They struggle to settle at night. They lie awake, hypervigilant and afraid. When they do fall asleep, they often wake multiple times, disturbed by nightmares, physical restlessness, or a sense of danger. Some children have never known the feeling of sleeping deeply and waking restored.
This isn’t just sad. It’s biologically destabilising and emotionally compounding.
The child who can’t sleep well also can’t regulate their emotions easily. Their impulse control, memory, and learning are impaired. Their immune system suffers. Their bodies miss out on the vital nighttime surge of human growth hormone, essential for healing, growth, and repair.
Sleep loss in trauma-affected children is more than a symptom. It’s an amplifier.
It magnifies anxiety. It worsens depression. It increases inflammation in the brain and body. It also disrupts the prefrontal cortex—the part of the brain that helps a child self-regulate, stay focused, and relate to others with empathy and awareness.
Research from the National Child Traumatic Stress Network found that children who experienced violence, abuse, or household disruption were significantly more likely to suffer from sleep disturbances, including insomnia, nightmares, and difficulty staying asleep (Briggs et al., 2017).
Another large study of adolescents at high risk of emotional and behavioural challenges found that childhood maltreatment disrupted nearly every dimension of sleep health—not just duration and quality, but also timing, consistency, and alertness during the day (Zarchev et al., 2024). Even when the trauma was no longer active, its effects on the body’s sleep systems remained deeply embedded.
The result is a downward spiral: broken sleep leads to breakdowns in behaviour, learning, health, and relationships. And too often, these children are misdiagnosed or misunderstood as “difficult,” “oppositional,” or “delayed” when they’re simply exhausted.
When we respond to the symptoms of that exhaustion with punishment, exclusion, or pressure, it only deepens the wound. Instead of helping, we reinforce their physiological stress, fueling a cycle that becomes harder and harder to break.
This is happening in homes. In foster care. In shelters across the world.
And it doesn’t just affect the child. Parents, educators, and carers are often left feeling overwhelmed and out of options—unaware that chronic sleep disruption is a substantial part of the problem.
If we want to change the trajectory for trauma-affected children, we must stop treating sleep as something that will simply return with time.
The evidence is clear: for many children, it doesn’t. And the consequences often extend into adulthood.
Sleep support must be recognised as a foundational part of trauma care, alongside safety, counselling, and emotional healing.
Because when a child is finally able to rest, real repair begins.
—
References
-
Briggs, E. C., Amaya-Jackson, L., Putnam, K. T., & Putnam, F. W. (2017). Trauma exposure and sleep disturbance in a sample of youth from the National Child Traumatic Stress Network Core Data Set. Journal of Traumatic Stress, 30(5), 522–530. Abstract available here
2. El-Sheikh, M., & Sadeh, A. (Eds.). (2015). Sleep and development: Advancing theory and research. Monographs of the Society for Research in Child Development, 80(1), 1–215. Read the study
3. Gregory, A. M., & Sadeh, A. (2012). Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Medicine Reviews, 16(2), 129–136. Read the study
4. Kajeepeta, S., Gelaye, B., Jackson, C. L., & Williams, D. R. (2015). Adverse childhood experiences are associated with adult sleep disorders: A systematic review. Sleep Health, 1(4), 259–265. Read the study
-
Zarchev, M., Kamperman, A. M., Hoepel, S. J. W., Hoogendijk, W. J. G., Mulder, C. L., & Grootendorst-van Mil, N. H. (2024). The association between childhood maltreatment and multidimensional sleep health in a high-risk adolescent population. Download the preprint