Disturbed Attachment in Children: A Factor in Sleep Disturbance, Altered Dream Production and Immune Dysfunction: 1: Not Safe to Sleep: Chronic Sleep Disturbance in Anxious Attachment

Folktales and literature supply innumerable examples of the negative effects of stress on sleep, but we do not need such material to learn that we will sleep poorly when we are unsettled or unhappy. Each of us has experienced a change in the quality of sleep when our daily routine has been modified or upset, even for apparently beneficial reasons such as going on holiday. At the other extreme, those who have lived through a major disaster or who have experienced traumatic events will know that such occurrences can have prolonged and disturbing effects on the quality of sleep and dreams.

There are many ways in which sleep and dreams can be disturbed. In this paper, I focus on a specific type of anxiety-related sleep dysfunction that includes an alteration both in physiological sleep stages and in dream function. A real or perceived failure in the protective role of an attachment figure plays a major part in the development of this type of dysfunction. There is clear evidence of this type of disturbance in infancy and early childhood, although it can occur at any time in life, including adulthood and old age.

In order to study sleep dysfunction, let us first consider what is currently known about normal patterns of sleep and dreams in adults and children. With this framework, I shall examine the effect of chronic anxiety on normal sleep physiology and dream function, and then review the consequent physiological and psychological symptoms. I suggest very specific factors linked aetiologically to anxiety level, perceived security of attachment, and various patterns of insecure attachment. In a sequel to this paper, I shall discuss the connection between sleep disturbance and dream quality and content, as well as the specific physiological changes which accompany such an alteration in sleep stages.

I hope that this introduction to the idea of “chronic sleep disturbance as a feature in disturbed attachment” will be useful to psychotherapists and other child care workers in i