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Current Psychiatry Reports

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01.12.2020 | Reproductive Psychiatry and Women's Health (CN Epperson and L Hantsoo, Section Editors)

Perinatal Insomnia and Mental Health: a Review of Recent Literature

verfasst von: Leslie M. Swanson, David A. Kalmbach, Greta B. Raglan, Louise M. O’Brien

Erschienen in: Current Psychiatry Reports | Ausgabe 12/2020

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Abstract

Purpose of Review

The perinatal period is a time of high risk for insomnia and mental health conditions. The purpose of this review is to critically examine the most recent literature on perinatal insomnia, focusing on unique features of this period which may confer specific risk, associations with depression and anxiety, and emerging work on perinatal insomnia treatment.

Recent Findings

A majority of perinatal women experience insomnia, which may persist for years, and is associated with depression and anxiety. Novel risk factors include personality characteristics, nocturnal perinatal-focused rumination, and obesity. Mindfulness and physical activity may be protective. Cognitive-behavioral therapy for insomnia is an effective treatment.

Summary

Perinatal insomnia is exceedingly common, perhaps due to factors unique to this period. Although closely linked to perinatal mental health, more work is needed to establish causality. Future work is also needed to establish the role of racial disparities, tailor treatments, and determine whether insomnia treatment improves perinatal mental health.

American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine; 2014.

Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7–10.PubMedPubMedCentral

Zhang B, Wing YK. Sex differences in insomnia: a meta-analysis. Sleep. 2006;29(1):85–93.CrossRef

Felder JN, Baer RJ, Rand L, Jelliffe-Pawlowski LL, Prather AA. Sleep disorder diagnosis during pregnancy and risk of preterm birth. Obstet Gynecol. 2017;130(3):573–81. https://doi.org/10.1097/aog.0000000000002132.CrossRefPubMed

Okun ML, O’Brien LM. Concurrent insomnia and habitual snoring are associated with adverse pregnancy outcomes. Sleep Med. 2018;46:12–9. https://doi.org/10.1016/j.sleep.2018.03.004.CrossRefPubMed

Pigeon WR, Bishop TM, Krueger KM. Insomnia as a precipitating factor in new onset mental illness: a systematic review of recent findings. Curr Psychiatry Rep. 2017;19(8):44. https://doi.org/10.1007/s11920-017-0802-x.CrossRefPubMed

•• Sivertsen B, Hysing M, Dorheim SK, Eberhard-Gran M. Trajectories of maternal sleep problems before and after childbirth: a longitudinal population-based study. BMC Pregnancy Childbirth. 2015;15:129. https://doi.org/10.1186/s12884-015-0577-1This longitudinal study followed perinatal women from pregnancy through the longest period to date (2 years postpartum) to establish the typical course of perinatal insomnia disorder using a population-based sample.CrossRefPubMedPubMedCentral

Morin CM, Belanger L, LeBlanc M, Ivers H, Savard J, Espie CA, et al. The natural history of insomnia: a population-based 3-year longitudinal study. Arch Intern Med. 2009;169(5):447–53. https://doi.org/10.1001/archinternmed.2008.610.CrossRefPubMed

Pallesen S, Sivertsen B, Nordhus IH, Bjorvatn B. A 10-year trend of insomnia prevalence in the adult Norwegian population. Sleep Med. 2014;15(2):173–9. https://doi.org/10.1016/j.sleep.2013.10.009.CrossRefPubMed

10.

Román-Gálvez RM, Amezcua-Prieto C, Salcedo-Bellido I, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A. Factors associated with insomnia in pregnancy: a prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2018;221:70–5. https://doi.org/10.1016/j.ejogrb.2017.12.007.CrossRefPubMed

11.

Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin North Am. 1987;10(4):541–53.CrossRef

12.

Bonnet MH, Arand DL. Hyperarousal and insomnia: state of the science. Sleep Med Rev. 2010;14(1):9–15. https://doi.org/10.1016/j.smrv.2009.05.002.CrossRefPubMed

13.

Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, et al. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010;14(1):19–31. https://doi.org/10.1016/j.smrv.2009.04.002.CrossRefPubMed

14.

Michopoulos V, Rothbaum AO, Corwin E, Bradley B, Ressler KJ, Jovanovic T. Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure. Arch Womens Ment Health. 2015;18(4):639–48. https://doi.org/10.1007/s00737-014-0467-y.CrossRefPubMed

15.

Kalmbach DA, Cheng P, Ong JC, Ciesla JA, Kingsberg SA, Sangha R, et al. Depression and suicidal ideation in pregnancy: exploring relationships with insomnia, short sleep, and nocturnal rumination. Sleep Med. 2020;65:62–73. https://doi.org/10.1016/j.sleep.2019.07.010.CrossRefPubMed

16.

Soldin OP, Guo T, Weiderpass E, Tractenberg RE, Hilakivi-Clarke L, Soldin SJ. Steroid hormone levels in pregnancy and 1 year postpartum using isotope dilution tandem mass spectrometry. Fertil Steril. 2005;84(3):701–10. https://doi.org/10.1016/j.fertnstert.2005.02.045.CrossRefPubMedPubMedCentral

17.

Dørheim SK, Garthus-Niegel S, Bjorvatn B, Eberhard-Gran M. Personality and perinatal maternal insomnia: a study across childbirth. Behav Sleep Med. 2016;14(1):34–48. https://doi.org/10.1080/15402002.2014.941063.CrossRefPubMed

18.

LeBlanc M, Merette C, Savard J, Ivers H, Baillargeon L, Morin CM. Incidence and risk factors of insomnia in a population-based sample. Sleep. 2009;32(8):1027–37.CrossRef

19.

Mindell JA, Jacobson BJ. Sleep disturbances during pregnancy. J Obstet Gynecol Neonatal Nurs. 2000;29(6):590–7.CrossRef

20.

Kalmbach DA, Cheng P, Sangha R, O’Brien LM, Swanson LM, Palagini L, et al. Insomnia, short sleep, and snoring in mid-to-late pregnancy: disparities related to poverty, race, and obesity. Nat Sci Sleep. 2019;11:301–15. https://doi.org/10.2147/NSS.S226291.CrossRefPubMedPubMedCentral

21.

Montgomery-Downs H, Insana S, Clegg-Kraynok M, Mancini L. Normative longitudinal maternal sleep: the first 4 postpartum months. Am J Obstet Gynecol. 2010;203(5):465.e1–7.CrossRef

22.

Leibenluft E. Do gonadal steroids regulate circadian rhythms in humans? J Affect Disord. 1993;29(2–3):175–81.CrossRef

23.

Lord C, Sekerovic Z, Carrier J. Sleep regulation and sex hormones exposure in men and women across adulthood. Pathol Biol (Paris). 2014;62(5):302–10. https://doi.org/10.1016/j.patbio.2014.07.005.CrossRef

24.

Drozdowicz-Jastrzębska E, Skalski M, Gdańska P, Mach A, Januszko P, Nowak RJ, et al. Insomnia, postpartum depression and estradiol in women after delivery. Metab Brain Dis. 2017;32(6):1913–8. https://doi.org/10.1007/s11011-017-0079-0.CrossRefPubMed

25.

Holmes TH, Rahe RH. The social readjustment rating scale. J Psychosom Res. 1967;11(2):213–8.CrossRef

26.

Bastien C, Vallires A, Morin C. Precipitating factors of insomnia. Behav Sleep Med. 2004;2(1):50–62.CrossRef

27.

Drake CL, Pillai V, Roth T. Stress and sleep reactivity: A prospective investigation of the stress-diathesis model of insomnia. Sleep. 2014;37(8):1295–304. https://doi.org/10.5665/sleep.3916.

28.

Palagini L, Cipollone G, Masci I, Novi M, Caruso D, Kalmbach DA, et al. Stress-related sleep reactivity is associated with insomnia, psychopathology and suicidality in pregnant women: preliminary results. Sleep Med. 2019;56:145–50. https://doi.org/10.1016/j.sleep.2019.01.009.CrossRefPubMed

29.

Dorheim SK, Bjorvatn B, Eberhard-Gran M. Can insomnia in pregnancy predict postpartum depression? A longitudinal, population-based study. PLoS One. 2014;9(4):e94674. https://doi.org/10.1371/journal.pone.0094674.CrossRefPubMedPubMedCentral

30.

Osnes RS, Eberhard-Gran M, Follestad T, Kallestad H, Morken G, Roaldset JO. Mid-pregnancy insomnia is associated with concurrent and postpartum maternal anxiety and obsessive-compulsive symptoms: a prospective cohort study. J Affect Disord. 2020;266:319–26. https://doi.org/10.1016/j.jad.2020.01.140.CrossRefPubMed

31.

Osnes RS, Roaldset JO, Follestad T, Eberhard-Gran M. Insomnia late in pregnancy is associated with perinatal anxiety: a longitudinal cohort study. J Affect Disord. 2019;248:155–65. https://doi.org/10.1016/j.jad.2019.01.027.CrossRefPubMed

32.

Montgomery-Downs HE, Clawges HM, Santy EE. Infant feeding methods and maternal sleep and daytime functioning. Pediatrics. 2010;126(6):e1562–8. https://doi.org/10.1542/peds.2010-1269.CrossRefPubMed

33.

Swain AM, O’Hara MW, Starr KR, Gorman LL. A prospective study of sleep, mood, and cognitive function in postpartum and nonpostpartum women. Obstet Gynecol. 1997;90(3):381–6.CrossRef

34.

Lillis TA, Hamilton NA, Pressman SD, Khou CS. The association of daytime maternal napping and exercise with nighttime sleep in first-time mothers between 3 and 6 months postpartum. Behav Sleep Med. 2018;16(6):527–41. https://doi.org/10.1080/15402002.2016.1239580.CrossRefPubMed

35.

Signal TL, Gander PH, Sangalli MR, Travier N, Firestone RT, Tuohy JF. Sleep duration and quality in healthy nulliparous and multiparous women across pregnancy and post-partum. Aust N Z J Obstet Gynaecol. 2007;47(1):16–22. https://doi.org/10.1111/j.1479-828X.2006.00672.x.CrossRefPubMed

36.

Tsai S-Y, Barnard K, Lentz M, Thomas K. Twenty-four hours light exposure experiences in postpartum women and their 2-10-week-old infants: an intensive within-subject design pilot study. Int J Nurs Stud. 2009;46(2):181–8.CrossRef

37.

McBean AL, Montgomery-Downs HE. What are postpartum women doing while the rest of the world is asleep? J Sleep Res. 2015;24(3):270–8. https://doi.org/10.1111/jsr.12265.CrossRefPubMed

38.

Matsumoto K, Shinkoda H, Kang MJ, Seo YJ. Longitudinal study of mothers’ sleep-wake behaviors and circadian time patterns from late pregnancy to postpartum – monitoring of wrist actigraphy and sleep logs. Biol Rhythm Res. 2003;34(3):265–78. https://doi.org/10.1076/brhm.34.3.265.18812.CrossRef

39.

Thomas KA, Burr RL, Spieker S, Lee J, Chen J. Mother-infant circadian rhythm: development of individual patterns and dyadic synchrony. Early Hum Dev. 2014;90(12):885–90. https://doi.org/10.1016/j.earlhumdev.2014.09.005.CrossRefPubMedPubMedCentral

40.

Martin-Fairey CA, Zhao P, Wan L, Roenneberg T, Fay J, Ma X, et al. Pregnancy induces an earlier chronotype in both mice and women. J Biol Rhythm. 2019;34(3):323–31. https://doi.org/10.1177/0748730419844650.CrossRef

41.

Quante M, Mariani S, Weng J, Marinac CR, Kaplan ER, Rueschman M, et al. Zeitgebers and their association with rest-activity patterns. Chronobiol Int. 2019;36(2):203–13. https://doi.org/10.1080/07420528.2018.1527347.CrossRefPubMed

42.

Jackson CL, Powell-Wiley TM, Gaston SA, Andrews MR, Tamura K, Ramos A. Racial/ethnic disparities in sleep health and potential interventions among women in the United States. J Women's Health. 2020;29(3):435–42. https://doi.org/10.1089/jwh.2020.8329.CrossRef

43.

• Feinstein L, McWhorter KL, Gaston SA, Troxel WM, Sharkey KM, Jackson CL. Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non-pregnant women in the United States. J Sleep Res e13000. https://doi.org/10.1111/jsr.13000This is the largest study to compare racial and ethnic disparities in sleep among pregnant and non-pregnant women.

44.

Kalmbach DA, Roth T, Cheng P, Ong JC, Rosenbaum E, Drake CL. Mindfulness and nocturnal rumination are independently associated with symptoms of insomnia and depression during pregnancy. Sleep Health. 2020;6(2):185–91. https://doi.org/10.1016/j.sleh.2019.11.011.CrossRefPubMed

45.

Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5 Pt 1):1071–83.CrossRef

46.

O’Hara MW, Swain AM. Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry. 1996;8(1):37–54. https://doi.org/10.3109/09540269609037816.CrossRef

47.

Emamian F, Khazaie H, Okun ML, Tahmasian M, Sepehry AA. Link between insomnia and perinatal depressive symptoms: a meta-analysis. J Sleep Res. 2019:e12858. https://doi.org/10.1111/jsr.12858.

48.

Manber R, Chambers AS. Insomnia and depression: a multifaceted interplay. Curr Psychiatry Rep. 2009;11(6):437–42.CrossRef

49.

Marques M, Bos S, Soares MJ, Maia B, Pereira AT, Valente J, et al. Is insomnia in late pregnancy a risk factor for postpartum depression/depressive symptomatology? Psychiatry Res. 2011;186(2–3):272–80. https://doi.org/10.1016/j.psychres.2010.06.029.CrossRefPubMed

50.

Suri R, Stowe ZN, Cohen LS, Newport DJ, Burt VK, Aquino-Elias AR, et al. Prospective longitudinal study of predictors of postpartum-onset depression in women with a history of major depressive disorder. J Clin Psychiatry. 2017;78(8):1110–6. https://doi.org/10.4088/JCP.15m10427.CrossRefPubMed

51.

Swanson LM, Pickett SM, Flynn H, Armitage R. Relationships among depression, anxiety, and insomnia symptoms in perinatal women seeking mental health treatment. J Women's Health. 2011;20(4):553–8. https://doi.org/10.1089/jwh.2010.2371.CrossRef

52.

Russell EJ, Fawcett JM, Mazmanian D. Risk of obsessive-compulsive disorder in pregnant and postpartum women: a meta-analysis. J Clin Psychiatry. 2013;74(4):377–85. https://doi.org/10.4088/JCP.12r07917.CrossRefPubMed

53.

Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–33. https://doi.org/10.7326/m15-2175.CrossRefPubMed

54.

Morgenthaler TT. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep (New York, NY). 2006;29(11):1415–9.

55.

Morin CM, Culbert JP, Schwartz SM. Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. Am J Psychiatry. 1994;151(8):1172–80.CrossRef

56.

Murtagh DRR, Greenwood KM. Identifying effective psychological treatments for insomnia: a meta-analysis. J Consult Clin Psychol. 1995;63(1):79–89.CrossRef

57.

Smith MT, Perlis ML, Park A, Smith MS, Pennington J, Giles DE, et al. Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. Am J Psychiatry. 2002;159(1):5–11.CrossRef

58.

Morin CM, Vallieres A, Guay B, Ivers H, Savard J, Merette C, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005–15. https://doi.org/10.1001/jama.2009.682.CrossRefPubMedPubMedCentral

59.

Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011;171(10):887–95. https://doi.org/10.1001/archinternmed.2010.535.CrossRefPubMedPubMedCentral

60.

Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA. 1999;281(11):991–9.CrossRef

61.

Backhaus J, Hohagen F, Voderholzer U, Riemann D. Long-term effectiveness of a short-term cognitive-behavioral group treatment for primary insomnia. Eur Arch Psychiatry Clin Neurosci. 2001;251(1):35–41.CrossRef

62.

Sivertsen B, Omvik S, Pallesen S, Bjorvatn B, Havik OE, Kvale G, et al. Cognitive behavioral therapy vs zopiclone for treatment of chronic primary insomnia in older adults: a randomized controlled trial. JAMA. 2006;295(24):2851–8. https://doi.org/10.1001/jama.295.24.2851.CrossRefPubMed

63.

Blom K, Jernelov S, Ruck C, Lindefors N, Kaldo V. Three-year follow-up comparing cognitive behavioral therapy for depression to cognitive behavioral therapy for insomnia, for patients with both diagnoses. Sleep. 2017;40(8). https://doi.org/10.1093/sleep/zsx108.

64.

Wu JQ, Appleman ER, Salazar RD, Ong JC. Cognitive behavioral therapy for insomnia comorbid with psychiatric and medical conditions: a meta-analysis. JAMA Intern Med. 2015;175(9):1461–72. https://doi.org/10.1001/jamainternmed.2015.3006.CrossRefPubMed

65.

Sedov ID, Goodman SH, Tomfohr-Madsen LM. Insomnia treatment preferences during pregnancy. J Obstet Gynecol Neonatal Nurs. 2017;46(3):e95–e104. https://doi.org/10.1016/j.jogn.2017.01.005.CrossRefPubMed

66.

•• Manber R, Bei B, Simpson N, Asarnow L, Rangel E, Sit A, et al. Cognitive behavioral therapy for prenatal insomnia: a randomized controlled trial. Obstet Gynecol. 2019;133(5):911–9. https://doi.org/10.1097/aog.0000000000003216This is the first published randomized, controlled trial of cognitive-behavioral therapy for insomnia in pregnancy; the study sample was also diverse with respect to race/ethnicity.CrossRefPubMedPubMedCentral

67.

Felder JN, Epel ES, Neuhaus J, Krystal AD, Prather AA. Efficacy of digital cognitive behavioral therapy for the treatment of insomnia symptoms among pregnant women: a randomized clinical trial. JAMA Psychiatry. 2020;77:484. https://doi.org/10.1001/jamapsychiatry.2019.4491.CrossRefPubMed

68.

Kalmbach DA, Cheng P, O’Brien LM, Swanson LM, Sangha R, Sen S, et al. A randomized controlled trial of digital cognitive behavioral therapy for insomnia in pregnant women. Sleep Med. 2020;72:82–92. https://doi.org/10.1016/j.sleep.2020.03.016.CrossRefPubMed

69.

Swanson LM, Flynn H, Adams-Mundy JD, Armitage R, Arnedt JT. An open pilot of cognitive-behavioral therapy for insomnia in women with postpartum depression. Behav Sleep Med. 2013;11(4):297–307. https://doi.org/10.1080/15402002.2012.683902.CrossRefPubMed

70.

Shaffer KM, Hedeker D, Morin CM, Ingersoll K, Thorndike F, Ritterband LM. Intra-individual variability in sleep schedule: effects of an internet-based cognitive-behavioral therapy for insomnia program and its relation with symptom remission. Sleep. 2020. https://doi.org/10.1093/sleep/zsaa115.

Titel: Perinatal Insomnia and Mental Health: a Review of Recent Literature
verfasst von: Leslie M. Swanson
David A. Kalmbach
Greta B. Raglan
Louise M. O’Brien
Publikationsdatum: 01.12.2020
Verlag: Springer US
Erschienen in: Current Psychiatry Reports / Ausgabe 12/2020
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI: https://doi.org/10.1007/s11920-020-01198-5

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