0728 Does Short Sleep Duration Increase Risk for Postpartum Weight Retention?

Abstract

Abstract Introduction About 75% of mothers in the United States have postpartum weight retention (PWR), which increases risk for adverse health outcomes in mother and child. Short sleep duration is an important health behavior linked to risk of weight gain in the general population. Although short sleep duration is common in postpartum, findings from the few studies examining sleep duration and PWR are mixed. Thus, we aimed to examine whether sleep duration at 6 months postpartum is associated with PWR at 12 months. We also explored agreement between self-reported and actigraphy-derived sleep duration. Methods This is a secondary analysis from a prospective cohort study investigating postpartum pelvic floor outcomes. Participants were healthy, age ≥18 years, and primiparous with a singleton birth. We measured sleep duration by triaxial, wrist accelerometer (Actigraph GT3X+) and by self-report using the Pittsburgh Sleep Quality Index (PSQI). Excessive PWR was defined as ≥7% of pre-pregnancy weight. Log-binomial regression assessed the relationship between sleep duration and PWR, adjusted for pre-pregnancy body mass index, gestational weight gain, and breastfeeding. We analyzed agreement between self-reported and actigraphy-derived sleep duration using Bland-Altman analysis and paired t-test. Results Participants (N=467; mean age=29.5±4.78 years; pre-pregnancy BMI= 24.4±5.03 kg/m2) were mostly White (91%) and educated (93%). After adjustment, sleep duration by actigraphy (Risk Ratio (RR)=0.96, 95% confidence interval (CI)=(0.87,1.06), p=0.44,) and by PSQI (RR=0.95, 95%CI=(0.84,1.07), p=0.38) was not associated with PWR. There was a statistically significant correlation between sleep duration by actigraphy and by PSQI (r=0.19, 95% CI=(0.10,0.28), p< 0.001). The limits of agreement were wide (-3.41 to 3.57 hours), and self-reported versus actigraphy-derived sleep duration was not statistically different (bias=0.08 hours, p=0.3313) indicating no pattern of underestimating or overestimating. Conclusion In contrast to some previous findings, sleep duration at 6 months postpartum was not associated with PWR at 12 months. The assessment of additional sleep dimensions, such as timing or efficiency, may further refine our understanding of how sleep affects PWR. Self-reported and actigraphy-derived measures of sleep duration evidenced wide discrepancies in postpartum women, suggesting that the method of sleep measurement may contribute to mixed findings related to sleep in this population. Support (if any)