The effect of sleep pattern changes on postpartum depressive symptoms

Beth A Lewis,Bess H Marcus,Melissa Avery,Katie Schuver,Dwenda Gjerdingen

doi:10.1186/s12905-017-0496-6

Abstract

BackgroundResearch 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.MethodsParticipants (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.ResultsOverall, 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.ConclusionsSleep 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.Trial registrationRegistered with ClinicalTrials.gov (NCT00961402) on August 18, 2009 prior to the start of the trial.

Highlights

Research indicates that poor sleep is associated with postpartum depression; little is known regarding this relationship among postpartum women who are at high for postpartum depression
We explored the relationship between depressive symptoms and changes in specific self-reported sleep problems including sleep duration, sleep disturbance, sleep latency, daytime dysfunction, sleep efficiency, sleep quality, and the use of sleep medications
The seven component subscales include subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction

Summary

Introduction

Research indicates that poor sleep is associated with postpartum depression; little is known regarding this relationship among postpartum women who are at high for postpartum depression. Postpartum depression is associated with numerous maternal and infant-related consequences including poor infant-child bonding [1], difficulty caring for the newborn [2], long-term behavior problems for the child [3], more weight retention for the mother [4], and future depression risk for both parents [5]. This is problematic given approximately 13–19% of mothers experience postpartum depression [6,7,8,9]. Lack of sleep can result in exhaustion, impatience, lower ability to concentrate, and a poor quality of life [16], which can all contribute to an increased risk for postpartum depression.

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