Maternal Sleep Research Articles

Effect of urban green space on parental sleep quality in the two years after childbirth

Abstract Background Green spaces are beneficial for sleep quality, particularly for maternal sleep quality, which in turn affects maternal health as well as the growth and development of offspring. However, few studies have examined the effect of green space on parental sleep quality, and even fewer have utilized the Normalized Difference Vegetation Index (NDVI). This study thus aims to explore the impact of urban green spaces on parental sleep quality during the two years after childbirth. Methods Participants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan cohort study. The study recruited and followed participants from early pregnancy to 6 years postpartum at five hospitals in Taipei since 2011. Participants who had used hypnotics were excluded. Sleep quality was assessed using self-reported questions at 24 months postpartum. Urban greenness was assessed using NDVI within a designated radius (250, 750, and 1500m) of participants’ residences during both the pregnancy and postpartum. Data were analyzed using multiple logistic regression. Results Out of the 804 pairs included in the analysis, we observed that an increase of 0.1 units in NDVI within a 1500m radius during pregnancy and postpartum periods (0-24 months) was associated with a 1.24 and 1.25-fold increase in maternal better sleep quality (95%CI:1.07,1.43 and 1.08, 1.43, respectively), after adjustment. These findings were consistent for both NDVI_250m and NDVI_750m. However, we did not find any association between NDVI and paternal sleep quality at any radius or time period. Conclusions We highlight a positive association between exposure to urban green spaces during perinatal periods and better maternal sleep quality. These findings have implications for parents in choosing their living environment, as well as for policymakers in urban planning and environmental improvement initiatives to promote both maternal and child health. Key messages • Urban green spaces have a positive impact on maternal sleep quality from pregnancy to postpartum periods. • The residential environment is critical to facilitate sleep quality and promote maternal and child health.

The debate continues on the best age to stop breastfeeding.

The ongoing debate on the optimal duration of breastfeeding in high-income countries is challenging. The decision to continue breastfeedingbeyond the introduction of solids according to WHO indications involves multifaceted considerations, such as nutritional needs, psychological factors and cultural influences, given the growing number of immigrants. The impact on maternal health, sleep routines and family dynamics should be carefully weighed too. CONCLUSION: Next studies should investigate associations of different modalities and periods of breastfeedingwith physical and neurodevelopmental outcomes, including psychological aspects. A personalised and gradual approach is suggested, guided by informed decisions and a supportive network.

Prenatal sleep health and risk of offspring ADHD symptomatology and associated phenotypes: a prospective analysis of timing and sex differences in the ECHO cohort

Sleep difficulties are common in pregnancy, yet poor prenatal sleep may be related to negative long-term outcomes for the offspring, including risk for attention-deficit/hyperactivity disorder (ADHD). Existing studies are few and have not examined timing of exposure effects or offspring sex moderation. We thus aimed to test the hypotheses that poor sleep health in pregnancy is associated with increased risk for ADHD symptoms and offspring sleep problems at approximately 4 years of age. Participants were 794 mother-child dyads enrolled in the NIH Environmental Influences on Child Health Outcomes Study (ECHO). Participants self-reported on sleep duration, quality, and disturbances during pregnancy and on children's ADHD symptoms and sleep problems on the Child Behaviour Checklist. Pregnant participants were 32.30±5.50 years and children were 46% female. 44 percent of pregnant participants identified as Hispanic or Latine; 49% identified as White. Second-trimester sleep duration was associated with offspring ADHD symptoms (b=-0.35 [95% CI=-0.57,-0.13], p=0.026), such that shorter duration was associated with greater symptomatology. Poorer sleep quality in the second trimester was also associated with increased ADHD symptomatology (b=0.66 [95% CI=0.18, 1.14], p=0.037). Greater sleep disturbances in the first trimester were associated with offspring ADHD (b=1.03 [95% CI=0.32, 1.03], p=0.037) and in the second trimester with sleep problems (b=1.53 [95% CI=0.42, 2.92], p=0.026). We did not document substantial offspring sex moderation. Poor prenatal sleep health, particularly quality and duration in the second trimester, may be associated with offspring risk of neurodevelopmental disorders and sleep problems in early childhood. Further research is needed to understand mechanisms, yet our study suggests that prenatal maternal sleep may be a modifiable target for interventions aimed at optimizing early neurodevelopment. NIH grants U2COD023375, U24OD023382, U24OD023319, UH3OD023320, UH3OD023305, UH3OD023349, UH3OD023313, UH3OD023272, UH3OD023328, UH3OD023290, K08MH117452 and NARSAD Young Investigator Award28545.

16.1 Experiences of Discrimination and Prenatal Maternal Sleep: Intergenerational Implications for Offspring Neurodevelopment

16.1 Experiences of Discrimination and Prenatal Maternal Sleep: Intergenerational Implications for Offspring Neurodevelopment

A Feasibility Study to Assess Sleep and Subsequent Breast Milk Volume Among Mothers With Hospitalized Preterm Infants.

Sleep is essential for optimal health, and disturbed postpartum sleep is associated with compromised infant attachment. The postpartum experience of mothers with preterm infants is unlike the biological norm, as they are separated from their infants and often express breast milk. The purpose of this study was to examine the feasibility of conducting a clinical research study among women with hospitalized preterm infants. We also explored for associations between maternal sleep patterns and sleep-related psychological states and subsequent breast milk volume. Participants were recruited from Magee-Womens Hospital, located in Pittsburgh, Pennsylvania New mothers completed daily sleep and pumping logs and scales to measure stress, trauma, depression, fatigue, and sleep quality. A total of 78 women were screened, 18 women consented, and a total of 8 participants completed the study. Screening from the postpartum unit increased recruitment. The participants experience worsening sleep quality over time, moderate stress, and fatigue. Stress, postnatal depression, and fatigue are negatively associated with milk volume. Postpartum recruitment with frequent follow-ups improved recruitment and retention. We present a preliminary association between maternal stress, fatigue, and depression, and subsequent breast milk volume. Sleep-related psychological states may negatively influence milk volume.

Five-year follow-up of a clinic-based sleep intervention for paediatric epilepsy: A randomized clinical trial.

Sleep disturbances in children with epilepsy are prevalent, and are associated with substantial adverse medical and psychosocial consequences. This study is a 5-year follow-up of a clinic-based sleep intervention study that randomized 100 toddlers and preschool-age children with epilepsy to a usual care group or a sleep intervention group. The intervention group received standard paediatric neurology care plus three education sessions during the child's routine clinic visit. The outcomes measured were: (1) child sleep by actigraphy and parental report; and (2) maternal sleep and depression. We aimed to evaluate the long-term benefits of a clinic-based sleep intervention for paediatric epilepsy. In total, 42 families (42.0%) participated. The average child's age at follow-up was 9.55 years. Thirty-eight (90.5%) children were not obtaining sufficient sleep at baseline, and 40 (95.2%) at the 5-year follow-up. The numbers of children with clinically significant sleep disturbances were 40 (95.2%) at baseline and 36 (85.7%) at the 5-year follow-up. Fourteen mothers (33.3%) had poor sleep quality and high depressive symptoms at both assessment time points. There were no differences (P > 0.05) in the child and maternal outcomes between the two trial arms. Overall, there was no evidence that a clinic-based sleep intervention that effectively improved multiple aspects of sleep in toddlers and preschool-age children with epilepsy had long-lasting beneficial effects. Our findings suggest that sleep interventions for families of children with epilepsy require ongoing reinforcement and monitoring during routine paediatric neurology care to prevent sleep problems from persisting or recurring.

Maternal obstructive sleep apnea aggravates metabolic dysfunction-associated fatty liver disease via HMGB1-TLR4 signaling-mediated endoplasmic reticulum stress in male offspring rats

Aims/hypothesisMaternal obstructive sleep apnea (MOSA) may inflict long-term metabolic effects on offspring. We hypothesize that MOSA increases the propensity for metabolic dysregulation in offspring and thus facilitates the development of metabolic dysfunction-associated fatty liver disease (MAFLD). This study aims to test the hypothesis and explore the underlying mechanism. MethodsThe MOSA rat model of upper airway obstruction was established and fecundated. The postweaning male offspring (n = 171) from both the control group and MOSA group were randomly fed the normal chow diet (NCD, n = 89) or high-fat diet (HFD, n = 82) for the next 5 months. Liver function, lipid profile, glucose, and insulin levels were measured. Expression levels of fibrosis-related proteins and endoplasmic reticulum (ER) stress-related proteins in liver tissues were assessed using immunohistochemistry and western blotting. ResultsMOSA increased body and liver weight in male offspring, along with augmented liver organ coefficient. Serum levels of aminotransferases, low-density lipoprotein, high-density lipoprotein, triglycerides, total cholesterol, total bile acid, fasting glucose, and insulin increased significantly. MOSA exacerbated HFD-induced hepatic steatosis and fibrosis. These effects were driven by the overactivated double-stranded RNA-activated protein kinase (PKR)-like eukaryotic initiation factor 2(PERK)-activating transcription factor (ATF)4-C/EBP homologous protein (CHOP) signaling pathway-induced ER stress, and hyperacetylation and release of high mobility group box-1(HMGB1) elicited above signaling in a TLR4-dependent manner. ConclusionsThese findings indicate that MOSA can exert prolonged adverse effects manifested as metabolic dysfunction in male offspring. Therefore, surveillance and management of OSA during pregnancy may be necessary to prevent and alleviate MAFLD in offspring.

Early-to-mid pregnancy sleep and circadian markers in relation to birth outcomes: An epigenetics pilot study

ABSTRACT Maternal sleep and circadian health during pregnancy are emerging as important predictors of pregnancy outcomes, but examination of potential epigenetic mechanisms is rare. We investigated links between maternal leukocyte DNA methylation of circadian genes and birth outcomes within a pregnancy cohort. Women (n = 96) completed a questionnaire and provided a blood sample at least once during early-to-mid pregnancy (average gestation weeks = 14.2). Leukocyte DNA was isolated and DNA methylation (average percent of methylation) at multiple CpG sites within BMAL1, PER1, and MTNR1B genes were quantified by pyrosequencing. Birth outcomes including gestational age at delivery, birthweight, and head circumference were abstracted from medical charts. Linear regression analyses were run between each CpG site with birth outcomes, adjusting for important confounders. Sleep duration and timing were assessed as secondary exposures. Higher methylation of a CpG site in PER1 was associated with smaller log-transformed head circumference (β=-0.02 with 95% CI −0.02 to 0.01; P, trend = 0.04). Higher methylation of MTNR1B (averaged across sites) was associated with lower log-transformed birthweight (−0.08 with 95% CI −0.16 to −0.01; P, trend = 0.0495). In addition, longer sleep duration was associated with higher birthweight (0.10 with 95% CI 0.02 to 0.18 comparing > 9 h to < 8 h; P, trend = 0.04). This pilot investigation revealed that higher methylation of PER1 and MTNR1B genes, and sleep duration measured in early-to-mid pregnancy were related to birth outcomes.

A longitudinal study of mother-infant objective and reported sleep in solo-mother and two-parent families.

This longitudinal study examined the development of mother-infant objective and reported sleep quality and duration in solo-mother families (i.e., mothers who decided to parent alone) in comparison to two-parent families. We recruited 134 solo mothers and 161 married mothers during pregnancy, most representing the middle to upper socioeconomic class in Israel. Assessments were conducted during pregnancy and at 4 and 8 months postpartum. Maternal and infant sleep were assessed with actigraphy and sleep diaries for 7 nights. Questionnaires were used to assess maternal insomnia symptoms, sleepiness, sleeping arrangements, and background variables. The comparison of sleep between solo-mother and two-parent families, at each assessment point, showed no differences in sleep duration, and only a few differences in sleep quality measures; these were partially explained by maternal age and breastfeeding. Nevertheless, solo mothers were more likely to share a bed with their infants. In both groups, trajectory analyses showed a decrease in maternal actigraphic and diary sleep quality measures from pregnancy to 4 months, followed by an increase from 4 to 8 months. However, maternal insomnia symptoms first declined, and then increased, and maternal sleep duration first lengthened and then shortened. Infant actigraphic and diary sleep quality increased in both groups from 4 to 8 months, whereas sleep duration decreased only in the "solo" group. In general, the findings suggest that objective and subjective sleep quality and sleep duration of solo-mother families, a growing yet unexplored family structure, do not seem to be significantly affected by the absence of a second parent. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association of Gestational Diabetes Mellitus Complicated With Short Sleep Duration and Child Neurodevelopmental Delay.

Gestational diabetes mellitus (GDM) is a risk factor for child neurodevelopmental delay. Maternal short sleep duration (SSD) may aggravate glucose metabolism disorder in women with GDM. However, it is unclear whether maternal SSD will further affect the neurodevelopmental outcomes of children. To identify the association of GDM complicated with SSD and child neurodevelopmental delay. This prospective study included 7069 mother-child pairs. Between 24 and 28 weeks of gestation, GDM was based on the 75-g oral-glucose-tolerance test. Self-reported sleep duration was collected via the Pittsburgh Sleep Quality Index questionnaire in the second (24-28 weeks) and third (32-36 weeks) trimesters. Outcomes of neurodevelopmental delay in 6 to 36 months postpartum were evaluated using Denver Developmental Screening Test-II and Gesell Development Diagnosis Scale. Compared with the unexposed group, women with "GDM + SSD" have the greatest risks of child neurodevelopmental delay (hazard ratio with 95% CI: 1.58 [1.03-2.44]). "GDM + SSD" was associated with the greatest risks of maternal-fetal glucose metabolic disorder. An interquartile ratio (0.58 mmol/L) increase in cord blood C-peptide was associated with the risk of child neurodevelopmental delay (hazard ratio with 95% CI: 1.28 [1.12-1.48]). The stronger linear association of maternal glucose metabolism profiles and C-peptide in women with "GDM + SSD" was also demonstrated. The proportion of association between "GDM + SSD" and child neurodevelopmental delay mediated by C-peptide was 14.4%. GDM complicated with SSD was associated with increased risk for child neurodevelopmental delay by enhancing the intergenerational association of maternal-fetal glucose metabolism disorder.

Subsequent maternal sleep deprivation aggravates neurobehavioral abnormalities, inflammation, and synaptic function in adult male mice exposed to prenatal inflammation.

Studies have suggested that prenatal exposure to inflammation increases the risk of neuropsychiatric disorders, including anxiety, depression, and cognitive dysfunction. Because of anatomical and hormonal alterations, pregnant women frequently experience sleep dysfunction, which can enhance the inflammatory response. The aim of this study was to explore the effects of maternal sleep deprivation on prenatal inflammation exposure-induced behavioral phenotypes in offspring and identify the associated mechanisms. Pregnant mice received an intraperitoneal injection of lipopolysaccharide (LPS) on gestational day 15 and were subsequently subjected to sleep deprivation during gestational days 15-21. Anxiety-like behavior was evaluated by the open field test and the elevated plus maze test. Depression-like behavior was assessed by the tail suspension test and the forced swimming test. Cognitive function was determined using the Morris water maze test. The levels of markers of inflammation and synaptic function were examined employing general molecular biological techniques. The results showed that prenatal exposure to LPS resulted in anxiety- and depression-like symptoms and learning and memory deficits, and these effects were exacerbated by maternal sleep deprivation. Furthermore, maternal sleep deprivation aggravated the prenatal LPS exposure-induced increase in the expression of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α and decrease in the levels of postsynaptic density-95 and synaptophysin in the hippocampus. Collectively, these results suggested that maternal sleep deprivation exacerbates anxiety, depression, and cognitive impairment induced by prenatal LPS exposure, effects that were associated with an inflammatory response and synaptic dysfunction.

Child sleep problems, maternal sleep and self-efficacy: Sleep's complicated role in maternal depression.

Depression, poor sleep duration and low self-efficacy are common in mothers of children with sleep problems. However, research rarely extends beyond the postpartum period. This study investigated the multifaceted relationship between child sleep and maternal depression in early motherhood. A confidential survey assessed child sleep problems, maternal sleep duration, parental self-efficacy and depressive symptoms in 477 Australian mothers of children aged 3 months to 5 years. We found no relationship between child age and maternal depression, supporting our decision to look beyond postpartum depression. Robust bootstrapped mediation modelling tested the hypothesis that both maternal sleep duration and parental self-efficacy would mediate child sleep problems as predictors of maternal depression. After controlling for child age, results showed a significant parallel mediation effect, demonstrating that maternal sleep duration and parental self-efficacy both mediate the relationship between child sleep problems on maternal depression. While the total effect of child sleep problems on maternal depression was statistically significant, after partialling out the effects of other variables, child sleep problems no longer predicted maternal depression. Akaike information criterion analyses supported the full model, with both mediators explaining meaningful variance in maternal depression. This study expands our knowledge beyond the postpartum period, and divulges the disparate effects of sleep deprivation and parental self-efficacy on the relationship between child sleep and depression in early motherhood. Maternal sleep duration and self-efficacy are modifiable risk factors of maternal depression, indicating possible efficacious treatments. Parental self-efficacy stands out as a direction for clinical practice and further psychobiological study.

Hypocretins, sleep, and maternal behavior.

The postpartum period is a demanding time during which mothers experience numerous physiological adaptations that enable them to care for their offspring while maintaining their wellbeing. Hypocretins, also known as orexins, are neuropeptides synthesized by hypothalamic neurons that play a fundamental role in several functions, including the promotion of wakefulness and motivated behaviors, such as maternal care. In this regard, several findings suggest that the activity of the hypocretinergic system increases in the early postpartum period and begins to decline as weaning approaches. In particular, hypocretins within the medial preoptic area, a crucial region during this period, modulate both maternal behavior and sleep. Although further studies are necessary to obtain a comprehensive understanding of the role of hypocretins in lactating females, current research suggests that this system participates in promoting active components of maternal behavior and regulating wakefulness and sleep adjustments during the postpartum period, potentially leading to increased wakefulness during this stage. These adaptive adjustments enable the mother to cope with the continuously changing demands of the pups.

The Relationship Between Maternal and Infant Sleep Duration Across the First Two Years.

The first objective of this study was to determine how mother-infant sleep duration is related across the first 2 years of life. The second objective was to determine whether these relationships change across the first 2 years of life. The third objective was to understand demographic and health predictors of the relationship between maternal and child sleep. Parents of 464 infants from the STRONG Kids 2 study reported their own and infants' nocturnal sleep duration and other health information (i.e., breastfeeding) at 3, 12, 18, and 24 months postpartum. Latent transition models revealed 2 mother-infant sleep profiles exist at 3 to 24 months. The low maternal sleep ( LMS ) pattern was characterized by lower maternal sleep duration than the recommended amount and lower infant sleep duration. The average maternal sleep ( AMS ) pattern was characterized by average maternal sleep duration meeting the recommended standard and average infant sleep duration. Approximately half of the mothers who started in the LMS profile transitioned to the AMS profile after 12 months postpartum. The sleep profiles stabilized after 12 months postpartum with limited transitions across 12 to 24 months. More infant-signaled nighttime wakings, later bedtimes, more infant sleep problems, and more exclusive breastfeeding were predictors of being in the LMS profile. Mother-infant sleep profiles stabilized after age 12 months, and mother-infant sleep profiles are driven by infant sleep quality during the night. The findings suggest the need to establish a healthy sleep routine for mothers and infants in the first year of life to promote longer-term sleep hygiene.

0743 Maternal Experiences of Gender Discrimination Are Associated with Worse Postpartum Sleep

Abstract Introduction Many new mothers experience poor sleep postpartum, which has been found to increase the risk of negative cardiovascular health and mental health outcomes. A few studies have found that experiences of racial/ethnic discrimination are associated with poor maternal sleep, but less is known about the effect of discrimination in other domains. Previous studies have also not accounted for the effect of infant sleep on maternal sleep, which is known to be a major influence in the first year after birth. This study aims to investigate the association between gender discrimination (GD) and postpartum maternal sleep, controlling for infant sleep. Methods The cohort comprised 506 mother-child dyads from the customer base of the Nanit Smart Baby Monitor. At 6–12 months postpartum (Mean±SD: 9.2±1.8), maternal experiences of GD (Everyday Discrimination Scale), perceived stress (Perceived Stress Scale (PSS)), and subjective sleep (Pittsburgh Sleep Quality Index) were assessed. Objective measures of infant sleep were obtained using the Nanit Smart Baby-Monitor. Logistic and linear regressions estimated the associations between maternal experiences of GD and maternal sleep, controlling for PSS, household income, infant age and sex, and objective infant sleep duration and wakings. Results 34.6% of mothers reported experiencing GD. The average PSS score was 15 (± 6.7). Infants had an average sleep duration of 10h (± 1.2) and an average of 3.1 (± 1.4) nighttime sleep wakings. Maternal experiences of GD were associated with shorter sleep duration (OR=1.67, CI=1.07-2.64) and more sleep disturbances (β = 0.77, CI= 0.04-1.49). The PSS was associated with more sleep disturbances (β = 0.11, CI= 0.05-0.16). Objective infant sleep duration was associated with subjective maternal sleep duration (OR=0.57, CI=0.47-0.69). Conclusion Maternal experiences of GD are associated with worse postpartum maternal sleep, suggesting that sleep could serve as a biological pathway relating GD and postpartum health. Future research is needed to investigate the long-term implications of maternal experiences of GD on maternal-fetal health. Support (if any) This research was supported by the Developmental Psychobiology Parent Infant Award and Nanit

0165 The Relationships between Early Maternal Sleep and Mother-Infant Bonding, and Infant Bedtime Difficulty Later: A Path Analysis

Abstract Introduction Infant sleep is influenced by biopsychosocial factors. However, the influences of early parental sleep quality and parent-infant bonding on infant sleep development are underexplored. This study aimed to examine the relationships between early maternal sleep quality and mother-infant bonding at 8 weeks postpartum, and infant bedtime difficulty at 3 months postpartum. Methods This study is a secondary analysis from the Snuggle Bug/Acurrucadito Study, an observational, longitudinal cohort study investigating the associations between 24-hr sleep-wake patterns, gut microbiome, and weight development among infants. Mothers (n=60, 31.5±5.4y, 66.3% married, 40.8% Hispanic, 41.5% &amp;lt; bachelor’s degree) and their full-term (≥37wk), singleton infants without major complications were recruited from Phoenix, Arizona metropolitan area. At 3 and 8 weeks, and 3 months of infant age, mothers completed the Pittsburgh Sleep Quality Index (PSQI, range:0-21, higher scores indicate worse sleep quality), and reported on infant bedtime difficulty, using a 5-point Likert scale (range:1-5) with higher scores indicating greater bedtime difficulty. Mother-infant bonding was measured by the Postpartum Bonding Questionnaire (PBQ, range:0-125) at 8-week age, with higher scores indicating greater bonding problems. Based on the Transactional Model of Infant Sleep, path analyses were conducted to identify the direct effect of 8-week PSQI scores, and indirect effects of 8-week PBQ total scores and 8-week bedtime difficulty on 3-month bedtime difficulty, using z scores for all variables and the 3-week bedtime difficulty as a covariate. Results At 8 weeks postpartum, the means of PSQI, PBQ, and bedtime difficulty were 5.8±2.6, 5.3±4.7, and 2.4±1.0, respectively. Bedtime difficulty at 3 months was 2.0±1.0. After adjusting for the 3-week bedtime difficulty, the 8-week maternal sleep quality was not directly associated with 8-week (β=.005, 95%CI [-0.31, 0.32]) or 3-month infant bedtime difficulty (β=-0.14, 95%CI [-0.43, 0.14]), whereas 8-week mother-infant bonding significantly mediated the relationship between 8-week maternal sleep quality and 3-month infant bedtime difficulty (β=0.1, 95%CI [0.02, 0.22]). Conclusion This study highlighted that early maternal sleep may disrupt early mother-infant bonding, which, in turn, may increase infant bedtime difficulty later in development. Future research should investigate how best to support healthy family sleep and bonding relationships. Support (if any) NIH/NHLBI R01HL147931

0775 Differences in subjective sleep measures in mothers and fathers of premature infants: A preliminary study

Abstract Introduction It has been documented that newborn’s sleep is strongly associated with maternal and paternal sleep. However, mothers seem to be more affected by their infant’s sleep than fathers. These associations are not well known in families of premature newborns yet. This was the objective of the present study. Methods 30 families of premature newborns (mothers, fathers and infants) participated in this study one month after discharge from the hospital. Parents completed, among other measures, sleep diaries during three consecutive weekdays for themselves and their child. Multiple linear regression analyses were computed to examine the association between sleep duration and nocturnal awakenings of the premature infant and their mothers’ and fathers’ sleep duration and number of awakenings during the night. Analyses were done separately for mothers and fathers. Results Regression models for parents’ sleep duration were significant and explained 31.7% of the variance in mothers’ sleep duration (p=.009) and 30.8% of the variance in fathers’ sleep duration (p=.01). Infants’ sleep duration was the only significant predictor in both models (□=.663, p=.005 and □=.670, p=.005, respectively for mothers and fathers). Thus, shorter sleep duration in premature infants predicted shorter sleep duration in mothers and fathers. Analyses of parents’ nocturnal awakenings showed that the model was significant for mothers (p&amp;lt;.001), but not for fathers (p=.372). The variables explained 73.4% of the variance in mothers’ awakenings, and infants’ nocturnal awakenings was the only significant predictor (□=.801, p&amp;lt;.001). Conclusion Our results suggest that premature infants’ sleep is strongly associated with mothers and fathers’ sleep. In addition, it seems that nocturnal awakenings are particularly associated with the mothers, but not the fathers’ awakenings during the night, which may be related to their involvement in feeding schedules during the night. Future studies should focus on sleep disturbances in families of preterm infants and on interventions targeted for both mothers and fathers that can be implemented to improve sleep in this population. Support (if any)

0625 Sleep when the baby sleeps? The effect of daytime nap behaviors on postpartum depression severity: a stress buffering hypothesis

Abstract Introduction The early postpartum is a time of expected maternal sleep loss, normalized as part of infant care. While short duration and disrupted nocturnal sleep are posited risk factors for postpartum depression (PPD), the role of daytime sleep remains less understood, despite the widespread recommendation that mothers sleep when their baby is sleeping. This study examined associations between napping, stress, and longitudinal PPD in a sample of in a sample of healthy first-time mothers, using a prospective ambulatory field study design. Methods Fifty primiparous women (62% non-White; mean age=32 years) without a history of sleep disorders or psychopathology completed 10-days (9-nights) of actigraphy and sleep diaries at postpartum week 6. Sleep variables included nighttime duration and efficiency, and daytime nap frequency, timing and duration. Participants completed 3-days of superimposed ecological momentary assessment (EMA) rating naturalistic infant-related stressors (task demand; effort-reward-imbalance) at four daily intervals. Hierarchical mixed models tested whether daytime sleep characteristics predicted lower depression levels (via Edinburgh Postnatal-Depression Scale - EPDS) at 6-weeks, 8-weeks, and 3-months postpartum. Time-varying within-person covariates included time-of-day, baseline depression and anxiety (via Generalized-Anxiety-Disorder-7 scores), and previous night sleep. To test the putative stress-protective role of napping, we examined pre-post nap differences in EMA ratings. Results Sixty percent (n = 30/47) of women napped regularly (&amp;gt;3x/1 week, between 1-5 PM, &amp;lt; 90 min by both diary and actigraphy), rating 80% of these naps “intentional.” Women with greater nap regularity at 6-weeks had lower depression levels at all timepoints (Betas = -2.4(1.6); -1.4(.5), -.5(.01) ps&amp;lt;.001, respectively), and less of an increase in depression symptoms at 3-months postpartum, compared to non-nappers [Beta(SE)=-1.2 (.5); R^2=.21; p&amp;lt;.001]. At 6-weeks, regular nappers reported lower stress post-nap (effort-reward-imbalance; demand) [Beta(SE)=-6.3(1.4); 1.2(.12,), R^2=.27, .32, respectively; ps&amp;lt;.01]. Conclusion This study demonstrates a contemporaneous mood-protective role of daytime sleep in a perinatal sample, using 24-hr objective sleep assessment coupled with daily assessments of naturalistic stressors. Moreover, these results provide support for the protective role of regular daytime sleep on development of PPD over time. Among new mothers who regularly nap, lowered post-nap stress may be one pathway through which daytime sleep buffers against PPD severity. Support (if any) NIMH-1R36MH118000-01, CTSI89431, T32-HL007713

Associations of self-reported sleep duration and sleep quality during pregnancy with newborn telomere length

BackgroundTelomere length (TL) at birth is considered a potential biomarker for lifelong health. Although maternal sleep disturbance has been linked to a series of adverse pregnancy outcomes, evidence on the effect of maternal sleep on newborn TL remains scarce. Therefore, we aim to investigate the association of maternal sleep duration and sleep quality with newborn TL. MethodsA total of 742 mother-newborn pairs were recruited from Wuhan Children’s Hospital between November 2013 and March 2015. Cord blood TL was measured using real-time quantitative polymerase chain reaction. Maternal sleep duration and quality during late pregnancy were obtained via questionnaires. Multivariate linear regression models were used to estimate the effects of maternal sleep duration and sleep quality on newborn TL. ResultsA total of 742 maternal-newborn pairs were included in the analyses. Mothers sleeping ≥10 hours had a 9.30% (95% CI: 2.09%, 15.99%) shorter newborn TL than those sleeping 7-<9 hours. However, the association in mothers with short sleep duration (<7 hours) did not reach statistical significance. Compared to mothers with good sleep quality, those with poor sleep quality had a 9.91% (95% CI: 4.06%, 15.40%) shorter newborn TL. We observed a joint effect of sleep duration and sleep quality on newborn telomere shortening. Women with sleep duration ≥10 hours and poor sleep quality were most likely to have newborns with short TL (percent change:−19.66%, 95% CI: −28.42, −9.84%). ConclusionsLong sleep duration and poor sleep quality during late pregnancy were associated with shorter newborn TL.

Trajectories of sleep quality and depressive symptoms in women from pregnancy to 3 months postpartum: a prospective cohort study.

Sleep quality and depression during pregnancy often affect women's adaptation to motherhood and are linked with adverse maternal and neonatal outcomes. Using a prospective cohort study comprising 190 pregnant women in central Taiwan, we investigated the trajectories of sleep quality and depressive symptoms and their associated predictors in perinatal women from pregnancy to postpartum. Sleep and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index and the Edinburgh Postnatal Depression Scale, respectively, from mid-pregnancy to 3 months postpartum. We used group-based trajectory modelling and logistic regression modelling to analyse the data collected from the structured questionnaires. Pregnant women (50.5% primipara) with a mean (standard deviation) age of 32.3 (4.1) years were included. We identified three distinctive classes of sleep quality trajectories during the perinatal period: 'stable good' (18.4%), 'increasing poor' (48.9%), and 'stable poor' (32.6%). We further detected three stable trajectories of depressive symptoms: 'stable low' (36.3%), 'stable mild' (42.1%), and 'stable high' (21.6%). A significant association between sleep quality and depression trajectories was evident (p < 0.001). High fatigue symptoms and low social support predicted the high trajectories of poor sleep and depressive symptoms. Distinctive dynamic sleep quality and stable depression trajectories were characterised. Our findings revealed that both the sleep and depression trajectories were closely associated with one another, with common predictors of fatigue symptoms and social support. The early assessment of maternal sleep and depression status is important for identifying at-risk women and initiating interventions tailored to perinatal women to improve their sleep and mental health.