Research indicates that poor sleep is associated with postpartum depression; however, little is known regarding this relationship among postpartum women who are at high for postpartum depression. This study examined the relationship between changes in self-reported sleep patterns (from six weeks to seven months postpartum) and depressive symptoms at seven months postpartum among women who were at high risk for postpartum depression.
Participants (n = 122) were postpartum women who were at an increased risk for postpartum depression (personal or maternal history of depression) and had participated in a randomized exercise intervention trial. For the current trial, participants completed the Pittsburgh Sleep Quality Index and Patient Health Questionnaire-9 (PHQ-9; assessed depression) at six weeks and seven months postpartum.
Overall, sleep problems significantly improved from six weeks to seven months postpartum. However, linear regression analyses indicated that worsening or minimal improvement of sleep problems were associated with higher depressive symptoms at seven month postpartum. Regarding the specific types of sleep problems, self-reported changes in sleep latency (i.e., how long it takes to fall asleep at night), daytime dysfunction (i.e., difficulty staying awake during the day), and sleep quality (i.e., subjective rating of sleep quality) were associated with higher levels of depressive symptoms.
Sleep problems typically improve during the postpartum phase. However, postpartum women who are at high risk for postpartum depression are at an increased risk for depressive symptoms later in the postpartum phase if sleep problems worsen or show only minimal improvement over time. Therefore, at the six-week postpartum clinic visit, women should receive education regarding potential worsening of sleep patterns and strategies for preventing sleep-related problems.
Registered with ClinicalTrials.gov (NCT00961402) on August 18, 2009 prior to the start of the trial.
Field T. Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Beh Dev. 2010;33:1–6. CrossRef
Banti S, Mauri M, Oppo A, Borri C, Rambelli C, Ramacciotti D, Montagnani MS, Camilleri V, Cortopassi S, Rucci P, Cassano GB. From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the Perinatal Depression–Research & Screening Unit study. Compr Psychiatry. 2011;52:343–51. CrossRefPubMed
Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evidence Report Technology Assessment (Summary). 2005;119:1–8.
O'Hara MW, Swain AM. Rates and risk of postpartum depression-a meta-analysis. Int Rev Psychiatry. 1996;8:37–54. CrossRef
Oppo A, Mauri M, Ramacciotti D, Camilleri V, Banti S, Borri C, Rambelli C, Montagnani MS, Cortopassi S, Bettini A, Ricciardulli S. Risk factors for postpartum depression: the role of the postpartum depression predictors inventory-revised (PDPI-R). Results from the Perinatal Depression-Research & Screening Unit (PNDReScU) study. Arch Womens Ment Health. 2009;12:239–49. CrossRefPubMed
Goyal D, Gay CL, Lee KA. Patterns of sleep disruption and depressive symptoms in new mothers. J Perinat Neonat Nur. 2007;21:123–9. CrossRef
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: VA: American Psychiatric Publishing; 2013. CrossRef
Tomfohr L, Buliga E, Letourneau N, Campbell T, Giesbrecht G. Trajectories of sleep quality and associations with mood during the perinatal period. Sleep. 2015;38(1237):45.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. J Psychiat Res. 1989;28:193–213. CrossRef
Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann. 2002;32:1–7. CrossRef
Martin A, Rief W, Klaiberg A, Braehler E. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatr. 2006;28:71–7. CrossRef
Gensichen J, Torge M, Peitz M, Wendt-Hermainski H, Beyer M, Rosemann T, Krauth C, Raspe H, Aldenhoff JB, Gerlach FM. Case management for the treatment of patients with major depression in general practices–rationale, design and conduct of a cluster randomized controlled trial–PRoMPT (primary care monitoring for depressive Patient's trial)[ISRCTN66386086]–study protocol. BMC Public Health. 2005;5:101. CrossRefPubMedPubMedCentral
First MB, Spitzer RL, Gibbons M, et al. Structured clinical interview for DSM-IV—clinical version (SCID-CV) (User’s guide and interview). Washington, D.C.: American Psychiatric Press, Inc.; 1997.
Lewis BA, Gjerdingen DK, Avery MD, Guo H, Sirard JR, Bonikowske AR, Marcus BHA. Randomized trial examining a physical activity intervention for the prevention of postpartum depression: the healthy mom trial. Ment Health Phys Act. 2014;7:42–9. CrossRef
Kutner M, Nachtsheim C, Neter J. Applied Linear Statistical Models. 4th ed. Irwin: McGraw-Hill; 2004.
Swanson LM, Flynn H, Adams-Mundy JD, Armitage R, Arnedt JT. (2013). An open pilot of cognitive-behavioral therapy for insomnia in women with postpartum depression. Beh Sleep Med. 2013;11:297–307. CrossRef
Parizek A, Mikesova M, Jirák R, Hill M, Koucký M, Pasková A, Velíková M, Adamcová K, Srámková M, Jandíková H, Dusková M. Steroid hormones in the development of postpartum depression. Physiol Res. 2014;63:S277–82. PubMed
- The effect of sleep pattern changes on postpartum depressive symptoms
Beth A. Lewis
Bess H. Marcus
- BioMed Central
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II