Abstract
BackgroundSleep problems are common during pregnancy and in the postnatal period, but there is still a lack of longitudinal population-based studies assessing the quantity and quality of sleep in these women. The aim of the current study was to examine the natural development and stability of insomnia and short sleep duration in women from pregnancy to two years postpartum.MethodsThis was a longitudinal cohort study (the Akershus Birth Cohort Study) of 1480 healthy women, who completed three comprehensive health surveys, at week 32 of pregnancy, week 8 postpartum and year 2 postpartum. The survey was composed of the following validated questionnaires: the Bergen Insomnia Scale, the Pittsburgh Sleep Quality Index and the Edinburgh Postnatal Depression Scale. Differences in sleep characteristics between the three assessment points were compared using Analyses of Variance with repeated measures, and logistic regression analyses were used to examine the stability of sleep variables.ResultsOne thousand four hundred and eighty women completed all three surveys, and the mean age at birth was 30.7 (+/−4.9). The prevalence of insomnia remained stable at 60 % at the first two time periods, and remained high at 41 % at year 2 postpartum. The mean sleep duration at the three time periods was 7 h 16 min, 6 h 31 min, and 6 h 52 min, respectively. Concurrent maternal depression could not explain the stability of sleep problems from during and immediately after pregnancy, to sleep problems 2 years postpartum.ConclusionBoth insomnia and short sleep duration were found to be very common both before and after pregnancy.
Highlights
Sleep problems are common during pregnancy and in the postnatal period, but there is still a lack of longitudinal population-based studies assessing the quantity and quality of sleep in these women
A longitudinal population-based study from Norway recently showed that nocturnal awakenings become less frequent when toddlers reach 18 months of age [6], suggesting that the mothers sleep may improve at this stage compared to the weeks and months immediately after the birth
Based on the above considerations, the aims of the current study were 1) to describe the natural development and stability of insomnia and short sleep duration from pregnancy to 8 weeks and 2 years postpartum, and 2) to examine to what extent the predictive effect of early sleep problems during pregnancy on maternal insomnia in toddlerhood may be explained by postnatal depressive symptoms
Summary
Sleep problems are common during pregnancy and in the postnatal period, but there is still a lack of longitudinal population-based studies assessing the quantity and quality of sleep in these women. Previous findings show that the first trimester is typically characterized by an increase in total sleep time and daytime sleepiness [7], whereas the majority of pregnant women experience reduced sleep quality and more nocturnal awakenings later in pregnancy [8,9,10,11,12,13], and immediately after birth [14,15,16] These findings are primarily based on Sivertsen et al BMC Pregnancy and Childbirth (2015) 15:129 small-scale studies, and there is still a lack of population-based studies assessing the quantity and quality of the sleep of women during pregnancy and postpartum. Insomnia often takes a chronic course [17], and it has yet to be investigated whether sleep problems emerging during pregnancy continue beyond the infant stage and into toddlerhood
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