Sleep quality during pregnancy may help predict emotional distress in postpartum period

1. In this study, first time mothers with longer sleep time during pregnancy were less likely to report high levels of anxiety and depression in the postpartum period.

2. Higher diary-based wake after sleep onset (ie. lower sleep quality) at 3 months post-partum predicted more moderate anxiety and depression symptoms compared to low symptomology. 

Evidence Rating Level: 2 (Good)

Sleep and mental health are strongly interrelated. Pregnancy and postpartum periods are times when sleep disturbances and mood fluctuations are common. Considering sleep is a modifiable risk factor, this study aimed to determine if sleep quantity and quality during pregnancy predict emotional distress during the postpartum period.

In this study, 215 nulliparous couples residing in Israel with a singleton, full term pregnancy and a healthy infant were voluntarily recruited. Couples with a preterm delivery, multiple gestations, and unhealthy newborns were excluded. The study required five home visits: the first in the third trimester of pregnancy, and the remainder at 3-,6-,12-, and 18-months postpartum. Study outcomes of sleep duration and quality [measured via wake time after sleep onset (WASO)] were recorded by actigraphy (objective measure) and diary recording (subjective measure). Furthermore, mothers completed questionnaires related to depression (Edinburgh Postnatal Depression Scale) and anxiety (Beck Anxiety Inventory) at all five time points.

Results indicated that women could be categorized into 4 classes of symptoms: high comorbidity (5.4%), moderate comorbidity (19.4%), low anxiety and decreasing depression symptomology (18.6%) and low symptomology (56.6%). Overall, mothers during pregnancy with shorter sleep durations were more likely to fall in the high or moderate comorbidity groups. Furthermore, higher WASO (ie lower sleep quality) scores at three months post-partum were more likely to be classified as having moderate symptomology compared to low symptomology. However, this study was limited in that data was collected in a homogenous, highly educated, two parent family community. Nonetheless, this study contributes to understanding and demonstrating the relationship between sleep and mood, which would be an important subject to address in clinical setting during pregnancy and the post-partum periods.

Click to read the study in Journal of Sleep Research

Image: PD

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