Intimate Partner Violence, Mental Health, and Associations with Self-Reported and Objective Sleep Quality in Pregnancy

Abstract Purpose This study investigates the interplay between intimate partner violence (IPV), mental health symptoms (posttraumatic stress, depression, and anxiety), and sleep quality in pregnant women. It examines the alignment between subjective (self-reported) and objective (actigraphy) measures of sleep and explores how IPV subtypes (physical violence, psychological aggression, and sexual coercion) influence these measures, considering the potential mediating role of mental health. Methods The study involved 46 pregnant women with a history of IPV exposure within the past year or serving as controls. Participants completed surveys assessing IPV, mental health, and self-reported sleep quality, followed by seven days of actigraphy monitoring. Statistical analyses included Spearman correlations, Bland–Altman plots for sleep measure agreement, and path analyses to explore relationships between IPV, mental health symptoms, and sleep parameters. Results Moderate correlations were observed between subjective and objective measures for time in bed and sleep onset latency (SOL). IPV subtypes showed distinct associations with sleep parameters: physical violence directly impacted total sleep time and efficiency, while sexual coercion influenced SOL. Mental health symptoms did not mediate these relationships significantly. Discrepancies between subjective and objective sleep measures highlighted potential biases linked to IPV exposure. Conclusion IPV exposure significantly disrupts sleep during pregnancy, with unique effects observed for different IPV subtypes. These disturbances occur independently of mental health symptoms, underscoring the need for routine sleep assessments and tailored interventions in prenatal care for IPV-exposed women. Integrating subjective and objective sleep evaluations can enhance understanding and management of sleep disturbances in this vulnerable population.