0627 Postpartum Insomnia and Poor Sleep Quality are Uniquely Predictive of Postpartum Mood Disorders

Abstract

Abstract Introduction Many postpartum women experience symptoms of depression (PPD) and anxiety (PPA). Insomnia and poor sleep quality are frequently reported by postpartum women and are risk factors for postpartum mood disorders. This longitudinal study sought to assess whether perinatal insomnia or sleep quality predicted depression and anxiety across each month of the first 6 months postpartum in women with a history of depression. Methods Pregnant women (N = 178) aged 18-45 years with a self-reported prior history of depression were recruited from social media in late pregnancy. None of the women were depressed at enrollment. In late pregnancy and for up to six months postpartum, women completed monthly online questionnaires including the ISQ, PSQI, EPDS, and GAD-7. Repeated-measures multilevel models were performed using the generalized linear mixed model command in the software IBM SPSS 28 to determine predictive associations across the postpartum. Demographics (age, education, race, and sex of baby) were statistically controlled for in these models. Results The rate of depression averaged (15.7%) and anxiety averaged (17.0%) across the postpartum. The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Insomnia in the postpartum predicted greater depressive and anxiety symptoms, even after controlling for prenatal insomnia. Likewise, poor sleep quality in the postpartum predicted greater depressive and anxiety symptoms after controlling for prenatal poor sleep quality scores. When considering clinical cutoffs of the EPDS ≥ 12 and GAD ≥ 10, postpartum insomnia and sleep quality uniquely predicted postpartum depression (OR = 5.69, 95% CI 3.33-9.74 and OR = 3.13, 95% CI 1.70 -5.77). Insomnia predicted postpartum anxiety (OR = 11.15, 95% CI 5.99-20.78), with sleep quality trending (OR = 1.76, 95% CI 0.99 -3.12). None of the demographic variables significantly contributed (P’s > 05). Conclusion Both postpartum insomnia and poor sleep quality contributed to clinical postpartum mood. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant to risk for postpartum mood. The consideration and treatment of both is important as they are uniquely associated with adverse outcomes for mother and child. Support (if any) Happiest Baby, Inc