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Lall MD, Jayaprakash N, Carrick A, Chang BP, Himelfarb NT, Thomas Y, Wong ML, Dobiesz V, Raukar NP. Consensus-Driven Recommendations to Support Physician Pregnancy, Adoption, Surrogacy, Parental Leave, and Lactation in Emergency Medicine. Ann Emerg Med 2024; 83:585-597. [PMID: 38639673 DOI: 10.1016/j.annemergmed.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/17/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024]
Abstract
The emergency department clinical environment is unique, and guidelines for promoting supportive and equitable workplace cultures ensure success and longevity for pregnant persons and parents in emergency medicine. There is paucity, variability, and dissatisfaction with current parental (historically referred to as maternity and paternity) leave policies. This paper describes the development of consensus-derived recommendations to serve as a framework for emergency departments across the country for incorporating family-friendly policies. Policies that foster a family-inclusive workplace by allowing for professional advancement without sacrificing personal values regardless of sex, gender, and gender identity are critical for emergency medicine recruitment and retention.
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Affiliation(s)
- Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
| | - Namita Jayaprakash
- Department of Emergency Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Angela Carrick
- Kansas College of Osteopathic Medicine, Wichita, KS; Department of Emergency Medicine, Hutchison Regional Medical Center, Hutchison, KS
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY
| | - Nadine T Himelfarb
- Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Ynhi Thomas
- Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX
| | - Matthew L Wong
- Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Valerie Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Neha P Raukar
- Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN
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2
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Kim M, Lyon-Caen S, Bayat S, Philippat C, Plancoulaine S. Parents' Sleep Multi-Trajectory Modelling from 3 to 36 Months Postpartum in the SEPAGES Cohort. Nat Sci Sleep 2024; 16:247-261. [PMID: 38465330 PMCID: PMC10924785 DOI: 10.2147/nss.s430024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/14/2023] [Indexed: 03/12/2024] Open
Abstract
Objective We investigated maternal and paternal sleep evolution from 3 to 36 months postpartum, their interrelations and predictors in the SEPAGES cohort. Methods Sleep information (night sleep duration [NSD], weekend daytime sleep duration [DSD] and subjective sleep loss [SSL]) was collected by self-administered questionnaires at 3, 18, 24 and 36 months postpartum in the SEPAGES French cohort that included 484 mothers and 410 fathers. Group-based multi-trajectory modelling was used to identify maternal, paternal and couple sleep multi-trajectory groups among 188 couples reporting sleep data for at least 2 time points. Multinomial logistic regression was used to assess associations between parental sleep multi-trajectories and early characteristics such as sociodemographic, chronotypes, child sex, birth seasonality or breastfeeding duration. Results We identified three maternal (M1-M3), paternal (F1-F3) and couple (C1-C3) sleep multi-trajectory groups with similar characteristics: a group with short NSD and high SSL prevalence (M1, F2, C2), a group with long NSD but medium SSL prevalence (M2, F3, C3) and a group with long NSD and low SSL prevalence (M3, F1, C1). Mothers with the shortest NSD (M1) were less likely to have a partner with long NSD (F2). As compared with long NSD and low SSL prevalence (C1), couples with short NSD and high SSL prevalence (C2) were less likely to have had a first child born in the autumn and fathers in C2 had a later chronotype. Conclusion We identified distinct sleep multi-trajectory groups for mothers, fathers and couples from 3- to 36-month postpartum. Sleep patterns within couples were homogeneous.
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Affiliation(s)
- Mihyeon Kim
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, F-75004, France
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Sam Bayat
- STROBE Inserm UA7 Laboratory & Grenoble University Hospital, Sept. of Pulmonology, Grenoble, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Sabine Plancoulaine
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, F-75004, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, WAKING, Bron, F-69500, France
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Romanzini LP, Ishikura IA, Pires GN, Tufik S, Andersen ML. The Impact of Maternity and Working Demands in Women's Sleep Pattern. Sleep Med Clin 2023; 18:481-487. [PMID: 38501520 DOI: 10.1016/j.jsmc.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
This literature review seeks to understand how motherhood and profession affect women's sleep. After the birth of a child, there is an increase in dissatisfaction with the quantity and quality of sleep. Awakenings and sleep disturbances are more frequent and can lead to increased fatigue and stress to reconcile household activities and work demands. These changes in sleep can lead to physical and/or psychological health problems. Sleep hygiene and social support become fundamental for the performance of the maternal tasks, reducing risks and increasing prevention of future problems, both for women and children.
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Affiliation(s)
- Lisie P Romanzini
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Isabela A Ishikura
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
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Power CJ, Fox JL, Elliott-Sale KJ, Bender AM, Dalbo VJ, Scanlan AT. Waking Up to the Issue! Research Inattention and Sex-Related Differences Warrant More Sleep Studies in Female Athletes. Sports Med 2023:10.1007/s40279-023-01963-5. [PMID: 37989830 DOI: 10.1007/s40279-023-01963-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
Understanding sleep patterns and behaviors of athletes is essential for developing targeted sleep-based interventions for implementation in practice. However, more than double the number of sleep studies have examined male athletes compared with female athletes, making the current understanding of sleep patterns, behaviors, and interventions among athletes disproportionately indicative of men. Consequently, this review demonstrates the need for more female-specific sleep data among athlete populations due to research inattention and sex-related differences. Specifically, this review identifies variations in sleep patterns and behaviors between male and female athletes, as well as physiological and lifestyle factors that potentially affect sleep patterns and behaviors across the lifespan, specifically in female athletes. In this regard, evidence suggests some female athletes experience longer sleep durations and better objective sleep quality, but similar or worse subjective sleep quality compared with male athletes. Additionally, scheduling training in the morning or throughout the day may benefit sleep in some female athletes. Considering sleep disorders, women may be at greater risk for insomnia and restless legs syndrome compared with men, which may be attributed to pregnancy, as well as a higher prevalence of anxiety and depressive symptoms, iron deficiency without anemia, and use of psychotropic medication among women. Finally, the menstrual cycle, menstrual disorders, oral contraceptive use, and the postpartum period have been shown to exert detrimental effects on sleep patterns and behaviors and should theoretically be considered when monitoring and managing sleep in female athletes.
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Affiliation(s)
- Cody J Power
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia.
| | - Jordan L Fox
- Rural Clinical School, The University of Queensland, Rockhampton, QLD, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Amy M Bender
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Absolute Rest, Austin, TX, USA
| | - Vincent J Dalbo
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Aaron T Scanlan
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
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Horwitz A, Bar-Shachar Y, Ran-Peled D, Finkelstein O, Ben-Zion H, Bar-Kalifa E, Meiri G, Tikotzky L. Sleep of mothers, fathers, and infants: a longitudinal study from pregnancy through 12 months. Sleep 2023; 46:zsad029. [PMID: 36788476 DOI: 10.1093/sleep/zsad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
STUDY OBJECTIVES This study assessed and compared mothers' and fathers' sleep trajectories from pregnancy and throughout the first year of the infant's life. We also examined associations between maternal, paternal, and infant sleep. METHODS Two hundred and thirty-two couples were recruited for the study during pregnancy. Data were collected during pregnancy and at 4, 8, and 12 months postpartum. Maternal, paternal, and infant sleep were monitored at home for seven nights, using actigraphy, sleep diaries, and the Insomnia Severity Index (ISI). RESULTS Mothers showed more impaired sleep quality than fathers, at all assessments, whereas fathers had shorter sleep duration. Based on the ISI, about 70% of mothers and 50% of fathers showed at least subclinical insomnia at the different assessments. Trajectory analyses (controlling for feeding method and sleeping arrangements) demonstrated a significant deterioration in diary-based and actigraphy sleep quality for both parents, from pregnancy to 4 months. Both parents and infants had an increase in sleep quality from 4 to 12 months, though some parental sleep variables showed a quadratic pattern with a decrease in sleep quality at 8 months. Statistically significant triadic associations at the different assessments were found between mothers', fathers', and infants' sleep. Maternal and infant sleep measures were more strongly correlated than paternal and infant sleep. CONCLUSIONS The findings highlight the importance of considering the family context of sleep, by demonstrating similarities and differences in the changes that sleep undergoes in new mothers and fathers and by showing how sleep is interrelated between all family members.
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Affiliation(s)
- Avel Horwitz
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Bar-Shachar
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dar Ran-Peled
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Omer Finkelstein
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hamutal Ben-Zion
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Meiri
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Kalogeropoulos C, Burdayron R, Laganière C, Dubois-Comtois K, Béliveau MJ, Pennestri MH. Sleep patterns and intraindividual sleep variability in mothers and fathers at 6 months postpartum: a population-based, cross-sectional study. BMJ Open 2022; 12:e060558. [PMID: 35995543 PMCID: PMC9403158 DOI: 10.1136/bmjopen-2021-060558] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Given that postpartum sleep is an important family process, further investigations including both mothers and fathers are necessary. The present study aimed to describe and compare sleep patterns and intraindividual night-to-night variability in mothers and fathers at 6 months postpartum using subjective and objective sleep measures. DESIGN Cross-sectional study. SETTING General community-based study in Montreal, QC, Canada. PARTICIPANTS Thirty-three couples (mothers and fathers) with no self-reported history of medical and mental health conditions participated in this study. RESULTS Parental sleep was measured across 10 consecutive nights using both a daily sleep diary and actigraphy. Results demonstrated that mothers' subjective and objective sleep was more fragmented compared with fathers (shorter longest consecutive sleep duration and more nocturnal awakenings; p<0.001). While mothers and fathers did not differ in their self-reported nocturnal sleep duration (p>0.05), actigraphy indicated that mothers obtained significantly longer nocturnal sleep duration (448.07 min±36.49 min) than fathers (400.96 min±45.42 min; p<0.001). Intraindividual sleep variability was revealed by relatively high coefficients of variation for parents across both subjective and objective indices related to sleep fragmentation (between 0.25 and 1.32). Actigraphy also demonstrated variability by mothers sleeping 6 hours consecutively on less than 3 nights, 27.27% (±22.81), and fathers on less than 6 nights, 57.27% (±24.53), out of 10. Associations were also found between parental sleep and family factors, such as age and infant sleep location (p<0.05). CONCLUSIONS These findings advance our knowledge of how sleep unfolds within the family system beyond the early postpartum weeks and/or months. Given the link between disturbed sleep and family functioning, the current research accentuates the importance of examining postpartum sleep patterns and variability in parents.
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Affiliation(s)
- Christopher Kalogeropoulos
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, Quebec, Canada
| | - Rebecca Burdayron
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, Quebec, Canada
| | - Christine Laganière
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, Quebec, Canada
| | - Karine Dubois-Comtois
- Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, Quebec, Canada
- Département de psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Marie-Julie Béliveau
- Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, Quebec, Canada
- Département de psychologie, Université de Montréal, Montreal, QC, Canada
| | - Marie-Helene Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Hôpital en santé mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, Quebec, Canada
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7
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Ran-Peled D, Bar-Shachar Y, Horwitz A, Finkelstein O, Bar-Kalifa E, Meiri G, Tikotzky L. Objective and subjective sleep and caregiving feelings in mothers of infants: a longitudinal daily diary study. Sleep 2022; 45:6569230. [DOI: 10.1093/sleep/zsac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/28/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
This study explored the links between mothers’ objective and subjective sleep and their caregiving feelings toward their infant (i.e. patience for the infant, desire to be with the infant, and anger toward the infant), using a diary study design. We were particularly interested in examining whether nights of lower sleep quality within individual mothers predict more negative maternal caregiving feelings the following day.
Methods
The sample included 151 women, who were recruited during pregnancy. Data were collected at 4 and 8 months after delivery. Maternal sleep was monitored at home for seven nights using actigraphy and sleep diaries. Mothers rated their caregiving feelings each evening.
Results
Multilevel modeling (controlling for depressive symptoms, feeding method, and background variables) revealed that actigraphic and subjective sleep variables were associated with maternal caregiving feeling, both at the between- and within-person levels. For example, lower sleep percent predicted reduced levels of maternal patience for the infant at 4 and 8 months (between-person effect). Moreover, when a mother had a lower sleep percent on a given night (compared to her average), she reported lower levels of patience for her infant the following day (within-person prospective effect).
Conclusions
The findings demonstrate, for the first time, that maternal nightly variations in objective and subjective sleep quality predict daily changes in maternal feelings toward her infant at two different assessment points. Improving maternal sleep quality might be an important target for future interventions which may help mothers to feel more positively toward their infants.
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Affiliation(s)
- Dar Ran-Peled
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Yael Bar-Shachar
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Avel Horwitz
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Omer Finkelstein
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Gal Meiri
- Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
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Ou CH, Hall WA, Rodney P, Stremler R. Correlates of Canadian mothers' anger during the postpartum period: a cross-sectional survey. BMC Pregnancy Childbirth 2022; 22:163. [PMID: 35227249 PMCID: PMC8883707 DOI: 10.1186/s12884-022-04479-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although some women experience anger as a mood problem after childbirth, postpartum anger has been neglected by researchers. Mothers' and infants' poor sleep quality during the postpartum period has been associated with mothers' depressive symptoms; however, links between mothers' sleep quality and postpartum anger are unclear. This study aimed to determine proportions of women with intense anger, depressive symptoms, and comorbid intense anger and depressive symptoms, and to examine mothers' and infants' sleep quality as correlates of postpartum anger. METHODS This cross-sectional survey study was advertised as an examination of mothers' and babies' sleep. Women, with healthy infants between 6 and 12 months of age, were recruited using community venues. The survey contained validated measures of sleep quality for mothers and infants, and fatigue, social support, anger, depressive symptoms, and cognitions about infant sleep. RESULTS 278 women participated in the study. Thirty-one percent of women (n = 85) reported intense anger (≥ 90th percentile on State Anger Scale) while 26% (n = 73) of mothers indicated probable depression (>12 on Edinburgh Postnatal Depression Scale). Over half of the participants rated their sleep as poor (n = 144, 51.8%). Using robust regression analysis, income (β = -0.11, p < 0.05), parity (β = 0.2, p < 0.01), depressive symptoms (β = 0.22, p < 0.01), and mothers' sleep quality (β = 0.10, p < 0.05), and anger about infant sleep (β = 0.25, p < 0.01) were significant predictors of mothers' anger. CONCLUSIONS Mothers' sleep quality and anger about infant sleep are associated with their state anger. Clinicians can educate families about sleep pattern changes during the perinatal time frame and assess women's mood and perceptions of their and their infants' sleep quality in the first postpartum year. They can also offer evidence-based strategies for improving parent-infant sleep. Such health promotion initiatives could reduce mothers' anger and support healthy sleep.
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Affiliation(s)
- Christine Hk Ou
- School of Nursing, University of Victoria, 3800 Finnerty Road, HSD Building, Room A402a, Victoria, British Columbia, V8P 5C2, Canada. .,Institute of Aging and Lifelong Health, University of Victoria, Victoria, Canada.
| | - Wendy A Hall
- School of Nursing, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Paddy Rodney
- School of Nursing, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
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Lollies F, Schnatschmidt M, Schlarb AA, Genuneit J. Child Sleep Problems Affect Mothers and Fathers Differently: How Infant and Young Child Sleep Affects Paternal and Maternal Sleep Quality, Emotion Regulation, and Sleep-Related Cognitions. Nat Sci Sleep 2022; 14:137-152. [PMID: 35115855 PMCID: PMC8801371 DOI: 10.2147/nss.s329503] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/26/2021] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Problems in infant and young child sleep can represent a serious challenge to parental behavior of mother and father. However, most research about the effect of infant and young child sleep on parenting has focused on mothers. Therefore, the present study aimed to explore the perception and consequences of infant and young child sleep problems of both parents. PARTICIPANTS AND METHODS Participants were recruited via random sampling at, eg, kindergartens in North Rhine Westphalia. The sample includes data of heterosexual German-speaking couples with children without any medical or psychopathological problems. For this study, parents were asked to complete the test battery with regard to their youngest child. As sampling was via the kindergarten, the range of child age was 4-68 months. A survey assessed data of parents (N=196, 46% female). The test battery contained the following questionnaires: Children Sleep Habits Questionnaire (CSHQ), Pittsburgh Sleep Quality Index (PSQI), Self-Report Measure for the Assessment of Emotion Regulation Skills (SEK-27), and a German version of the Infant Sleep Vignettes Interpretation Scale (ISVIS). For the outcome variables of parental sleep as well as for parental emotional competence, the statistical tests of ANOVA were used, and for parental sleep-related cognitions with the grouping variables of infant and young child sleep as well as parental gender, a MANOVA was used. According to the analysis of group differences, the age of the child was also included additional to the grouping variable of parental gender and children's sleep. RESULTS Mothers and fathers in this sample were equally aware of their children's sleep problems and reported similar sleep quality and emotion regulation themselves (all p > 0.05). Mothers as well as fathers of children with sleep problems had lower parental sleep quality (F(1, 183) = 110.01, p < 0.001) and emotion regulation (F(1, 184) = 143.16, p < 0.001) compared to parents of children without sleep problems. In children under 26 months of age, the child's age seemed to have less negative impact on the father's sleep quality (F(1, 183) = 5.01, p < 0.001) and emotion regulation (F(1, 184) = 0.72, p < 0.05) than on the outcomes of the mother. With regard to sleep-related cognition, there were statistically significant effects of parental gender (F(2, 185) = 44.39, p < 0.001) and interaction effects of parental gender × child sleep problems observed (F(2, 185) = 31.91, p < 0.001). CONCLUSION The conclusion from this survey refers to the role of the father. According to the results, an association between paternal emotional competence, sleep quality as well as their sleep-related cognitions and infants and toddlers sleep behavior could be assumed in addition to and independent of the results of mothers. We would highlight the urgent need of inclusion of fathers in infant and developmental sleep research. In the context of sleep intervention, both parents should be provided with ongoing support to improve their sleep quality and competence in emotion regulation.
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Affiliation(s)
- Friederike Lollies
- Faculty for Psychology and Sports Science, Bielefeld University, Bielefeld, North Rhine Westphalia, 33015, Germany
| | - Marisa Schnatschmidt
- Faculty for Psychology and Sports Science, Bielefeld University, Bielefeld, North Rhine Westphalia, 33015, Germany
| | - Angelika A Schlarb
- Faculty for Psychology and Sports Science, Bielefeld University, Bielefeld, North Rhine Westphalia, 33015, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Saxony, 04103, Germany
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10
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Children's sleep and fathers' health and wellbeing: A systematic review. Sleep Med Rev 2021; 61:101570. [PMID: 34896729 DOI: 10.1016/j.smrv.2021.101570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/14/2021] [Accepted: 11/03/2021] [Indexed: 11/24/2022]
Abstract
Night-waking is typical across infancy and early childhood, inevitably disrupting family sleep. For some children, sleep problems develop and endure throughout childhood. This systematic review focused on fathers, and synthesised the evidence pertaining to the effects of children's sleep (from birth to 12 years) on fathers' health and wellbeing. A total of 29 studies were included. Key outcomes reported for fathers were: sleep and fatigue; mental and general health; and family functioning. An association between child sleep and father's sleep was observed when child's sleep was measured via actigraphy or paternal report, but not when measured via maternal report, suggesting that mothers may not always be aware of disruptions that awaken fathers. Findings showed poorer child sleep was associated with poorer general health and wellbeing among fathers, however, associations of poor child sleep with depression were fewer, and less frequent than those reported for mothers in the same households. Poor child sleep was negatively associated with the quality of family relationships, both within the couple and between parent and child. Future studies seeking to understand the interplay of child sleep and family wellbeing should apply objective measurement of sleep and integrate formal measures of family dynamics into the study design.
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11
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Fatigued surgeons: A thematic analysis of the causes, effects and opportunities for fatigue mitigation in surgery. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2021.100382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Goodstein MH, Stewart DL, Keels EL, Moon RY. Transition to a Safe Home Sleep Environment for the NICU Patient. Pediatrics 2021; 148:peds.2021-052046. [PMID: 34155135 DOI: 10.1542/peds.2021-052046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Of the nearly 3.8 million infants born in the United States in 2018, 8.3% had low birth weight (<2500 g [5.5 lb]) and 10% were born preterm (gestational age of <37 completed weeks). Many of these infants and others with congenital anomalies, perinatally acquired infections, and other disease require admission to a NICU. In the past decade, admission rates to NICUs have been increasing; it is estimated that between 10% and 15% of infants will spend time in a NICU, representing approximately 500 000 neonates annually. Approximately 3600 infants die annually in the United States from sleep-related deaths, including sudden infant death syndrome International Classification of Diseases, 10th Revision (R95), ill-defined deaths (R99), and accidental suffocation and strangulation in bed (W75). Preterm and low birth weight infants are particularly vulnerable, with an incidence of death 2 to 3 times greater than healthy term infants. Thus, it is important for health care professionals to prepare families to maintain their infant in a safe sleep environment, as per the recommendations of the American Academy of Pediatrics. However, infants in the NICU setting commonly require care that is inconsistent with infant sleep safety recommendations. The conflicting needs of the NICU infant with the necessity to provide a safe sleep environment before hospital discharge can create confusion for providers and distress for families. This technical report is intended to assist in the establishment of appropriate NICU protocols to achieve a consistent approach to transitioning NICU infants to a safe sleep environment as soon as medically possible, well before hospital discharge.
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Affiliation(s)
- Michael H Goodstein
- Division of Newborn Services, WellSpan Health, York, Pennsylvania .,Department of Pediatrics, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania
| | - Dan L Stewart
- Department of Pediatrics, Norton Children's and School of Medicine, University of Louisville, Louisville, Kentucky
| | - Erin L Keels
- National Association of Neonatal Nurse Practitioners, National Association of Neonatal Nurses, Chicago, Illinois.,Neonatal Advanced Practice, Nationwide Children's Hospital, Columbus, Ohio
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13
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Kalogeropoulos C, Burdayron R, Laganière C, Béliveau MJ, Dubois-Comtois K, Pennestri MH. Investigating the link between sleep and postpartum depression in fathers utilizing subjective and objective sleep measures. Sleep Med X 2021; 3:100036. [PMID: 34169272 PMCID: PMC8144731 DOI: 10.1016/j.sleepx.2021.100036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/07/2021] [Accepted: 04/29/2021] [Indexed: 11/01/2022] Open
Abstract
Background While fathers are at risk of developing poorer sleep and depressive symptoms in the postpartum period, they represent an understudied population in the literature. The present study aimed to explore the association between sleep and postpartum depressive symptoms in fathers using subjective and objective sleep measures. Methods Fifty-four fathers reporting no history of depression took part in this cross-sectional study. At 6 months postpartum, paternal sleep was assessed for 2 weeks utilizing a self-report daily sleep diary, a self-report perceived sleep quality rating, and actigraphy. In the same period, depressive symptoms in fathers were assessed with the Center for Epidemiologic Studies-Depression Scale (CES-D). Results Regression analyses showed that paternal subjective sleep variables captured by the sleep diary (total nocturnal sleep time and number of night awakenings) were not related to postpartum depressive symptoms. However, self-reported perceived sleep quality was significantly associated with postpartum depressive symptom severity in fathers independently of demographic variables related to depression. Alternatively, the objective sleep variables (total nocturnal sleep time, number of night awakenings, sleep efficiency, and wake after sleep onset), measured by actigraphy, did not demonstrate a significant relationship with paternal depression scores. Conclusions These findings highlight the importance of perceived sleep quality, along with better understanding its association with postpartum depressive symptoms. Implementing a multi-measure approach enabled us to expand our knowledge about how different facets of sleep relate to postpartum depression, specifically in fathers. The results have important implications for the development of clinical interventions targeting paternal sleep and mood in the postpartum period.
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Affiliation(s)
- Christopher Kalogeropoulos
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Hôpital en Santé Mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, QC, Canada
| | - Rebecca Burdayron
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Hôpital en Santé Mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, QC, Canada
| | - Christine Laganière
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Hôpital en Santé Mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, QC, Canada
| | - Marie-Julie Béliveau
- Hôpital en Santé Mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, QC, Canada.,Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Karine Dubois-Comtois
- Hôpital en Santé Mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, QC, Canada.,Département de Psychologie, Université Du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Marie-Hélène Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Hôpital en Santé Mentale Rivière-des-Prairies (CIUSSS-NIM), Montreal, QC, Canada
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14
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Damato EG, Burant CJ, Brubaker JA, Decker MJ. Sleep pattern gender differences and fragmentation in postpartum parents of twins. Sleep Sci 2021; 14:118-124. [PMID: 35082980 PMCID: PMC8764939 DOI: 10.5935/1984-0063.20200101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 12/28/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Parents of newborn twins are at risk for both shortened sleep duration and sleep discontinuity. The purpose of this study was to characterize weekday and weekend sleep duration, sleep continuity, and awakenings in both mothers and fathers of newborn twins during the first 3 months at home. MATERIAL AND METHODS Sleep-wake parameters were assessed at two time points using self-report diaries and actigraphy in 75 families with newborn twins. To assess sleep on weekdays and weekends with minimal subject burden, actigraphy recordings of both parents commenced at 9:00 p.m. Saturday and terminated at 9:00 p.m. Tuesday. RESULTS Mean sleep duration over 24 hours for parents of twins ranged between 6.7 and 7.5 hours during the first 3 months postpartum and did not significantly differ on weekdays or weekends for mothers. Weekend sleep was more fragmented for fathers at both one month and three months with more awakenings, compared to weekday sleep. Mothers had more fragmented night sleep compared to fathers at one month. In contrast, at three months postpartum fathers had shorter total sleep time and night sleep time, but fewer night awakenings on weekdays than mothers. No differences were observed in weekend sleep duration or sleep patterns between mothers and fathers at three months. DISCUSSION Consolidated sleep periods for both parents averages three hours or less during the first three months postpartum and sleep for both parents is fragmented. In families with newborn twins, the extent of sleep disruption for mothers and fathers is similar.
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Affiliation(s)
- Elizabeth G Damato
- Case Western Reserve University, Frances Payne Bolton School of Nursing - Cleveland - Ohio -United States
- Case Western Reserve University, Department of Physiology & Biophysics - Cleveland - Ohio - United States
- Case Western Reserve University, Department of Pulmonary, Critical Care, Sleep Medicine - Cleveland - Ohio -United States
| | - Christopher J Burant
- Case Western Reserve University, Frances Payne Bolton School of Nursing - Cleveland - Ohio -United States
- Louis Stokes Cleveland VA Medical Center, Geriatric Research, Education, and Clinical Center - Cleveland -Ohio - United States
| | - Jennifer A Brubaker
- Cleveland Clinic Foundation, General Pediatrics, Lorain Family Health Center - Cleveland - Ohio -United States
| | - Michael J Decker
- Case Western Reserve University, Department of Physiology & Biophysics - Cleveland - Ohio - United States
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15
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Da Costa D, Lai JK, Zelkowitz P. A prospective study on the course of sleep disturbances in first-time fathers during the transition to parenthood. Infant Ment Health J 2021; 42:222-232. [PMID: 33491788 DOI: 10.1002/imhj.21911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study examined sleep disturbances in first-time fathers from the third trimester of their partner's pregnancy to 2 months postpartum to determine prevalence, incidence, and persistence of sleep disturbances and identify associated determinants. METHODS Men expecting their first child were recruited from local prenatal classes and university-affiliated obstetric clinics. During their partner's third trimester of pregnancy and 2 months postpartum, 459 men completed standardized online self-report questionnaires measuring sociodemographics, lifestyle, and psychosocial variables and sleep quality. RESULTS Disturbed sleep (Pittsburgh Sleep Quality Index [PSQI] global score >5) increased from 29.6% during the third trimester to 44.7% at 2 months postpartum. The incidence of poor sleep at 2 months postpartum was 33.7%. Among men with disturbed sleep at the antenatal assessment, 70.6% continued to have sleep disturbances at 2 months postpartum. An increase in depressive symptoms and higher parenting stress was independently associated with onset and persistence of disturbed sleep at 2 months postpartum. CONCLUSIONS Sleep is compromised in expectant and new fathers. Strategies aimed at improving sleep, depressed mood, and managing the challenges of parenting may be important components to include in prenatal interventions aimed at enhancing the transition to parenthood and infant development.
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Affiliation(s)
- Deborah Da Costa
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jonathan K Lai
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
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16
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Kim W, Ju YJ, Lee SY. Association Between Recent Experience of Childbirth and Sleep Quality in South Korean Women: Results from a Nationwide Study. Nat Sci Sleep 2021; 13:467-475. [PMID: 33814936 PMCID: PMC8009764 DOI: 10.2147/nss.s297964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/20/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Although women commonly report deterioration of sleep quality postpartum, this relationship has been less studied in East Asian countries. This study investigated the association between recent experience of childbirth and sleep quality in South Korean women and additionally examined how healthy practice behavior interplays in the stated relationship. METHODS Data from the 2018 Community Health Survey were used. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI). Women who responded to have given birth in the past year were categorized as having a recent experience of childbirth. The general characteristics of the study population were investigated using chi-square test. The association between the dependent and independent variables was analyzed using multivariate logistic regression analysis. RESULTS Of a total of 41,708 study participants, 16,877 (40.5%) individuals reported poor sleep quality. Poor sleep quality was more common in women with a recent experience of childbirth (48.4%) than those without (40.0%). Compared to individuals without a recent experience of childbirth, those with such an experience were more likely to show poor sleep quality (OR 1.50, 95% CI 1.34-1.68). Such differences were reduced in individuals with a healthy lifestyle. CONCLUSION Recent experience of childbirth was associated with higher likelihoods of poor sleep quality in women. The degree of risks found was reduced in individuals practicing a healthy lifestyle habit. The findings infer the need to monitor and address sleep-related disturbances commonly reported among postpartum women.
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Affiliation(s)
- Woorim Kim
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Yeong Jun Ju
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea
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17
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Kenny S, Burdayron R, E M Lannes É, Dubois-Comtois K, Béliveau MJ, Pennestri MH. Mothers' and fathers' sleep: Is there a difference between first-time and experienced parents of 6-month-olds? J Sleep Res 2020; 30:e13238. [PMID: 33274547 DOI: 10.1111/jsr.13238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/20/2020] [Accepted: 11/02/2020] [Indexed: 11/30/2022]
Abstract
Sleep disruption and deprivation are highly prevalent among parents of an infant. However, most postpartum sleep studies focus solely on mothers, and few studies have investigated whether sleep differs between first-time and experienced parents. The present study aimed to determine whether self-reported sleep duration and quality differ between first-time and experienced mothers and fathers during the postpartum period. A total of 111 parents (54 couples and three single mothers) of 6-month-old infants completed a 2-week sleep diary to evaluate measures of sleep duration, sleep continuity, and sleep quality. An analysis of covariance model was used to compare the sleep variables of first-time to experienced parents. Breastfeeding frequency, infant sleep location, depression, education, and work status were used as co-variables. First-time mothers reported a longer consecutive nocturnal sleep duration (mean [SEM] 297.34 [17.15] versus 246.01 [14.79] min, p < .05), fewer nocturnal awakenings (mean [SEM] 1.57 [0.20] versus 2.12 [0.17], p < .05), and rated their sleep quality higher (mean [SEM] score 7.07 [0.36] versus 5.97 [0.30], p < .05) than experienced mothers, while total nocturnal sleep duration did not differ. There were no differences in subjective sleep measures between first-time and experienced fathers. The present study indicates that experienced mothers reported more fragmented sleep and perceived having worse sleep quality than first-time mothers, but that paternal sleep did not differ as a function of parental experience. These findings have clinical implications for healthcare professionals working with families of various configurations and sizes.
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Affiliation(s)
- Samantha Kenny
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal, QC, Canada
| | - Rebecca Burdayron
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal, QC, Canada
| | - Émilie E M Lannes
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal, QC, Canada
| | - Karine Dubois-Comtois
- Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal, QC, Canada.,Département de psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Marie-Julie Béliveau
- Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal, QC, Canada.,Département de psychologie, Université de Montréal, Montreal, QC, Canada
| | - Marie-Hélène Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Ile-de-Montréal, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal, QC, Canada
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18
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Duthie EA. In-Hospital Newborn Falls Associated With a Sleeping Parent: The Case for a New Paradigm. Hosp Pediatr 2020; 10:1031-1037. [PMID: 33229336 DOI: 10.1542/hpeds.2020-0112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A newborn fall to the floor from a sleeping parent's arms in the immediate postpartum period may result in a skull fracture, head bleed, and transfer to the NICU for observation. These harmful consequences galvanized frontline clinicians to prevent these tragic accidents, but, a decade later, they continue at a stubbornly low, persistent level. In this article, I suggest that a misunderstanding of sleep science may be a barrier to effective interventions. The science of sleep is presented to inform a new paradigm that would have greater potential of eliminating dangerous newborn falls.
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Affiliation(s)
- Elizabeth A Duthie
- Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
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19
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Wynter K, Wilson N, Thean P, Bei B, Fisher J. Psychological Distress, Alcohol Use, Fatigue, Sleepiness, and Sleep Quality: An Exploratory Study Among Men Whose Partners Are Admitted to a Residential Early Parenting Service. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Karen Wynter
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University,
- School of Nursing and Midwifery – Western Health Partnership, Faculty of Health, Deakin University,
| | - Nathan Wilson
- School of Psychological Sciences, Monash University, and
| | | | - Bei Bei
- School of Psychological Sciences, Monash University, and
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University,
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20
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Wynter K, Francis LM, Fletcher R, McBride N, Dowse E, Wilson N, Di Manno L, Teague S, Macdonald JA. Sleep, mental health and wellbeing among fathers of infants up to one year postpartum: A scoping review. Midwifery 2020; 88:102738. [DOI: 10.1016/j.midw.2020.102738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022]
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21
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Cook G, Appleton JV, Wiggs L. Parentally reported barriers to seeking help and advice for child sleep from healthcare professionals. Child Care Health Dev 2020; 46:513-521. [PMID: 31925800 DOI: 10.1111/cch.12739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Healthcare professionals (HCPs), largely doctors, paediatricians, health visitors, midwives, and practice nurses, are in a good position to provide information, help, advice, or guidance to parents for child sleep. However, evidence suggests that there is a gap between the number of parents who desire assistance from HCPs and those that make use of these sources, yet very little is known about the reason for this apparent disparity. The aim of this study was to understand the barriers reported by parents to consulting HCPs about child sleep. METHODS In this study, 266 U.K.-based parents of children aged 6-36 months old completed an online questionnaire (between October 2015 and October 2016) about their help-seeking behaviours in relation to child sleep. This included reporting perceived barriers to consulting HCPs for child sleep information and advice about problems. RESULTS Thematic analysis highlighted five themes, which parents reported acted as barriers to them consulting HCPs. Specifically, parents perceived HCPs to have a lack of knowledge or training around the topic of child sleep and that advice would be limited in terms of breadth of information or management options that would be offered. Parents were also concerned about wasting their own or HCPs' time, perceived there was a lack of continuity in the information they received, and held concerns about possible negative consequences for their family if they shared details about any child sleep difficulties. CONCLUSIONS Possible practical approaches to address the barriers reported by parents are highlighted. This includes improving training around the topic of child sleep for HCPs and adapting the content or manner in which the topic of child sleep and any associated issues are addressed with parents.
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Affiliation(s)
- Georgia Cook
- Psychology Department, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Jane V Appleton
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Luci Wiggs
- Psychology Department, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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22
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Ngai F, Lam W. The experience of first‐time Hong Kong Chinese fatherhood: A qualitative exploratory study. Nurs Health Sci 2020; 22:723-731. [DOI: 10.1111/nhs.12719] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Fei‐Wan Ngai
- School of Nursing The Hong Kong Polytechnic University Kowloon Hong Kong
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23
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Richter D, Krämer MD, Tang NKY, Montgomery-Downs HE, Lemola S. Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and fathers. Sleep 2020; 42:5289255. [PMID: 30649536 DOI: 10.1093/sleep/zsz015] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 12/06/2018] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES To examine the changes in mothers' and fathers' sleep satisfaction and sleep duration across prepregnancy, pregnancy, and the postpartum period of up to 6 years after birth; it also sought to determine potential protective and risk factors for sleep during that time. METHODS Participants in a large population-representative panel study from Germany reported sleep satisfaction and sleep duration in yearly interviews. During the observation period (2008-2015), 2541 women and 2118 men reported the birth of their first, second, or third child and provided longitudinal data for analysis. Fixed-effects regression models were used to analyze changes in sleep associated with childbirth. RESULTS Sleep satisfaction and duration sharply declined with childbirth and reached a nadir during the first 3 months postpartum, with women more strongly affected (sleep satisfaction reduction compared with prepregnancy: women, 1.81 points on a 0 to 10 scale, d = 0.79 vs. men, 0.37 points, d = 0.16; sleep duration reduction compared with prepregnancy: women, 62 min, d = 0.90 vs. men, 13 min, d = 0.19). In both women and men, sleep satisfaction and duration did not fully recover for up to 6 years after the birth of their first child. Breastfeeding was associated with a slight decrease in maternal sleep satisfaction (0.72 points, d = 0.32) and duration (14 min, d = 0.21). Parental age, household income, and dual vs. single parenting were unrelated, or only very weakly related, to improved sleep. CONCLUSIONS Following the sharp decline in sleep satisfaction and duration in the first months postpartum, neither mothers' nor fathers' sleep fully recovers to prepregnancy levels up to 6 years after the birth of their first child.
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Affiliation(s)
- David Richter
- German Institute for Economic Research (DIW Berlin, Deutsches Institut für Wirtschaftsforschung e.V.), Berlin, Germany
| | - Michael D Krämer
- German Institute for Economic Research (DIW Berlin, Deutsches Institut für Wirtschaftsforschung e.V.), Berlin, Germany
| | - Nicole K Y Tang
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | | | - Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, United Kingdom
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24
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The Mother-Infant Sleep Nexus: Night-Time Experiences in Early Infancy and Later Outcomes. THE MOTHER-INFANT NEXUS IN ANTHROPOLOGY 2020. [DOI: 10.1007/978-3-030-27393-4_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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25
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One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials. Int J Obes (Lond) 2019; 44:57-68. [PMID: 31292531 DOI: 10.1038/s41366-019-0410-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores. SUBJECTS/METHODS In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants. RESULTS Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of -1.6 kg (95% CI -2.5, -0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months. CONCLUSIONS Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.
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26
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Considering Sleep, Mood, and Stress in a Family Context: A Preliminary Study. Clocks Sleep 2019; 1:259-272. [PMID: 33089168 PMCID: PMC7445857 DOI: 10.3390/clockssleep1020022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/09/2019] [Indexed: 11/25/2022] Open
Abstract
Background: During the first years of life, parental sleep strongly depends on child’s sleep quality. Poor parental sleep may relate to increased stress and negative mood. However, there is a lack of sleep studies focusing on all family members. This study aimed to investigate the relationship between sleep, mood, and stress in mothers, fathers and children. Methods: Data were obtained from 65 parental couples and 65 children (2 to 36 months). Data on sleep for all family members and stress of parents were completed by both mothers and fathers through questionnaires and sleep diaries. Results: Toddlers’ positive mood before nocturnal sleep was significantly associated with reduced wake times after sleep onset. Mothers reported worse sleep quality compared to fathers. Shorter sleep onset latency in fathers and better sleep efficiency in mothers were linked with better self-reported mood upon awakening. In mothers, but not in fathers, poor sleep quality was associated with higher perceived stress. Conclusion: Results suggest bidirectional relationships between sleep and mood in children, mothers and fathers. Moreover, results evidence poorer sleep in mothers, compared to fathers, which was linked with increased parenting stress. This gender gap should be further considered in studies with larger samples and in clinical contexts.
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27
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Maternal Sleepiness and Risk of Infant Drops in the Postpartum Period. Jt Comm J Qual Patient Saf 2019; 45:337-347. [DOI: 10.1016/j.jcjq.2018.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/23/2022]
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28
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Seeking social support and postpartum depression: A pilot retrospective study of perceived changes. Midwifery 2019; 71:56-62. [DOI: 10.1016/j.midw.2019.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/24/2018] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
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29
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Wynter K, Wilson N, Thean P, Bei B, Fisher J. Psychological and sleep-related functioning among women with unsettled infants in Victoria, Australia: a cross-sectional study. J Reprod Infant Psychol 2018; 37:413-428. [DOI: 10.1080/02646838.2018.1556787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Karen Wynter
- Global Public Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Nursing & Midwifery – Western Health Partnership, Deakin University, Melbourne, Australia
| | - Nathan Wilson
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Patsy Thean
- Early Parenting Centre, Masada Private Hospital, Melbourne, Australia
| | - Bei Bei
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jane Fisher
- Global Public Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Marthinsen GN, Helseth S, Fegran L. Sleep and its relationship to health in parents of preterm infants: a scoping review. BMC Pediatr 2018; 18:352. [PMID: 30419873 PMCID: PMC6231258 DOI: 10.1186/s12887-018-1320-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/24/2018] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Sleep is essential for human health and functioning. Parents of preterm infants are susceptible to sleep disturbances because of stress related to the preterm birth. Poor sleep has the potential to affect parental health and well-being. The aim of this study was to identify and map evidence on sleep and its relationship to health in parents of preterm infants. No review has summarized the evidence on this topic. METHODS A scoping review was conducted. Seven health and medical electronic research databases were searched for relevant quantitative and qualitative primary studies, including grey literature. The search was performed March 2-7, 2017. RESULTS Ten American studies and one Australian study were included in the review. Most research was quantitative and focused on maternal sleep and mental health within the first two weeks after the childbirth. Both objective and subjective sleep measures were used to study sleep at the hospital; actigraphs were not used after discharge. Maternal sleep was poor early postpartum, and this was associated with negative health outcomes. Two cohort studies compared sleep in mothers of preterm and term infants, but the results were conflicting. In one qualitative study, fathers described their inability to catch up on sleep after homecoming with a preterm baby. CONCLUSIONS Quantitative studies reporting on maternal sleep early postpartum was most frequently occurring in the results. Qualitative research on the topic was identified as a knowledge gap. More cultural and geographical breadth, including research on fathers' sleep, is recommended in future research.
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Affiliation(s)
- Gunhild Nordbø Marthinsen
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
| | - Sølvi Helseth
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, NO-0130 Oslo, Norway
| | - Liv Fegran
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
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Malish S, Arastu F, O'Brien LM. A Preliminary Study of New Parents, Sleep Disruption, and Driving: A Population at Risk? Matern Child Health J 2016; 20:290-7. [PMID: 26541593 DOI: 10.1007/s10995-015-1828-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Drowsy driving is estimated to be a causal factor in 2-16 % of vehicular crashes. Several populations are reported to be at high risk for drowsy driving accidents, including shift workers, teenage drivers, medical residents, and pilots. Although new parents are known to have significant sleep disruption, no study has investigated vehicular accidents or near miss accidents in this population. METHODS A preliminary cross-sectional, anonymous survey of parents who had given birth within the previous 12 months. Participants were asked about their sleep, including validated measures of sleep disruption, their driving patterns, and information about near miss traffic accidents and actual crashes. RESULTS Overall, 72 participants were enrolled. A large proportion of participants had poor sleep including approximately 30 % with daytime sleepiness, 60 % with poor daytime function and two-thirds with poor sleep quality. The mean sleep duration was only 6.4 h. Although most participants drove <100 miles per week, 22.2 % reported at least one near miss accident and 5.6 % reported a crash. Sleep problems were more common in those with near miss accidents and actual crashes than in those without. Of note, poor sleep quality was associated with a sixfold increase in near miss accidents even after accounting for other factors. CONCLUSION Poor sleep is common in new parents and we provide preliminary evidence that sleep disruption in this population is associated with near miss motor vehicle accidents. Drowsy driving results in thousands of unnecessary serious injuries and fatalities each year; raising public awareness that new parents are a high-risk group is important.
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Affiliation(s)
- Sterling Malish
- Department of Neurology, Sleep Disorders Center, Michael Aldrich Sleep Disorders Laboratory, University of Michigan, C728 Med Inn, 1500 East Medical Center Drive, Box 5845, Ann Arbor, MI, 48109-0845, USA
| | - Fatema Arastu
- Department of Neurology, Sleep Disorders Center, Michael Aldrich Sleep Disorders Laboratory, University of Michigan, C728 Med Inn, 1500 East Medical Center Drive, Box 5845, Ann Arbor, MI, 48109-0845, USA
| | - Louise M O'Brien
- Department of Neurology, Sleep Disorders Center, Michael Aldrich Sleep Disorders Laboratory, University of Michigan, C728 Med Inn, 1500 East Medical Center Drive, Box 5845, Ann Arbor, MI, 48109-0845, USA.
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA.
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Grandner MA, Williams NJ, Knutson KL, Roberts D, Jean-Louis G. Sleep disparity, race/ethnicity, and socioeconomic position. Sleep Med 2016; 18:7-18. [PMID: 26431755 PMCID: PMC4631795 DOI: 10.1016/j.sleep.2015.01.020] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/14/2015] [Accepted: 01/20/2015] [Indexed: 12/26/2022]
Abstract
Sleep represents a set of biological functions necessary for the maintenance of life. Performing these functions, though, requires that an individual engage in behaviors, which are affected by social and environmental factors. Race/ethnicity and socioeconomic position represent categories of factors that likely play a role in the experience of sleep in the community. Previous studies have suggested that racial/ethnic minorities and the socioeconomically disadvantaged may be more likely to experience sleep patterns that are associated with adverse health outcomes. It is possible that disparities in sleep represent a pathway by which larger disparities in health emerge. This review (1) contextualizes the concept of race/ethnicity in biomedical research, (2) summarizes previous studies that describe patterns of sleep attainment across race/ethnicity groups, (3) discusses several pathways by which race/ethnicity may be associated with sleep, (4) introduces the potential role of socioeconomic position in the patterning of sleep, and (5) proposes future research directions to address this issue.
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Affiliation(s)
- Michael A Grandner
- Behavioral Sleep Medicine Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, USA.
| | - Natasha J Williams
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, New York University Langone Medical Center, New York University School of Medicine, New York, NY, USA
| | | | - Dorothy Roberts
- University of Pennsylvania Law School, Philadelphia, PA, USA; Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA; Department of Africana Studies, University of Pennsylvania, Philadelphia, PA, USA
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, New York University Langone Medical Center, New York University School of Medicine, New York, NY, USA
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McBean AL, Kinsey SG, Montgomery-Downs HE. Effects of a single night of postpartum sleep on childless women's daytime functioning. Physiol Behav 2016; 156:137-47. [PMID: 26776447 DOI: 10.1016/j.physbeh.2016.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/16/2015] [Accepted: 01/12/2016] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVES The maternal postpartum period is characterized by sleep fragmentation, which is associated with daytime impairment, mental health disturbances, and changes in melatonin patterns. In addition to sleep fragmentation, women undergo a complex set of physiological and environmental changes upon entering the postpartum period, confounding our understanding of effects of postpartum sleep disturbance. The primary study aim was to understand the basic impact of a single night of postpartum-like sleep fragmentation on sleep architecture, nocturnal melatonin levels, mood, daytime sleepiness, and neurobehavioral performance. MEASUREMENTS AND RESULTS For one week prior to entry into the laboratory, eleven healthy nulliparous women kept a stable sleep-wake schedule (verified via actigraphy). Participants contributed three consecutive nights of laboratory overnight polysomnography: (1) a habituation/sleep disorder screening night; (2) a baseline night; and (3) a sleep fragmentation night, when participants were awakened three times for ~30min each. Self-reported sleep quality and mood (Profile of Mood States survey) both decreased significantly after sleep fragmentation compared to baseline measurements. Unexpectedly, daytime sleepiness (Multiple Sleep Latency Test) decreased significantly after sleep fragmentation. Experimental fragmentation had no significant effect on time spent in nocturnal sleep stages, urinary 6-sulfatoxymelatonin concentration, or psychomotor vigilance test performance. Participants continued to provide actigraphy data, and daily PVTs and self-reported sleep quality assessments at home for one week following sleep fragmentation; these assessments did not differ from baseline values. CONCLUSIONS While there were no changes in measured physiological components of a single night of postpartum-like experimental sleep fragmentation, there were decreases in self-reported measures of mood and sleep quality. Future research should examine the effects of multiple nights of modeling postpartum-like sleep fragmentation on objective measures of sleep and daytime functioning.
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Affiliation(s)
- Amanda L McBean
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Steven G Kinsey
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Moore Simas TA, Corvera S, Lee MM, Zhang N, Leung K, Olendzki B, Barton B, Rosal MC. Understanding multifactorial influences on the continuum of maternal weight trajectories in pregnancy and early postpartum: study protocol, and participant baseline characteristics. BMC Pregnancy Childbirth 2015; 15:71. [PMID: 25885002 PMCID: PMC4389494 DOI: 10.1186/s12884-015-0490-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 02/25/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Maternal and offspring immediate and long-term health are affected by pregnancy weight gain and maternal weight. This study was designed to determine feasibility of: 1) recruiting a socio-economically and racially/ethnically diverse sample of pregnant women into a longitudinal observational study, including consenting the women for serial biologic specimen evaluations; 2) implementing comprehensive assessments (including biologic, anthropometric, behavioral, cognitive/psychosocial and socio-demographic, and cultural measures) at multiple time points over the study period, including collecting biologic specimens at planned and unplanned pregnancy delivery times; and 3) retaining the sample for one year into the postpartum period. Additionally, the study will provide preliminary data of associations among hypothesized predictors, mediators and moderators of pregnancy and post-partum maternal and infant weight trajectories. The study was conceptualized under a Biopsychosocial Model using a lifespan approach. Study protocol and baseline characteristics are described. METHODS/DESIGN We sought to recruit a sample of 100 healthy women age 18-45 years, between 28-34 weeks gestation, with singleton pregnancies, enrolled in care prior to 17 weeks gestation. Women provide written consent for face-to-face (medical history, anthropometrics, biologic specimens), and paper-and-pencil assessments, at five time points: baseline (third trimester), delivery-associated, and 6-weeks, 3-months and 6-months postpartum. Additional telephone-based assessments (diet, physical activity and breastfeeding) administered baseline and three-months postpartum. Infant weights are collected until 1-year of life. We seek to retain 80% of participants at six-months postpartum and 80% of offspring at 12-months. 110 women were recruited. Sample characteristics include: mean age 28.3 years, BMI 25.7 kg/m(2), and gestational age at baseline visit of 32.5 weeks. One-third of cohort was non-white, over a quarter were Latina, and almost a quarter were non-US born. The cohort majority was multigravida, had graduated high school and/or had higher levels of education, and worked outside the home. DISCUSSION Documentation of study feasibility and preliminary data for theory-driven hypothesis of maternal and child factors associated with weight trajectories will support future large scale longitudinal studies of risk and protective factors for maternal and child health. This research will also inform intervention targets facilitating healthy maternal and child weight.
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Affiliation(s)
- Tiffany A Moore Simas
- Department of Obstetrics & Gynecology, Division of Research, University of Massachusetts Medical School/UMass Memorial Health Care, Memorial Campus - 119 Belmont Street, Worcester, MA, 01605, USA.
| | - Silvia Corvera
- Department of Medicine, Program in Molecular Medicine, University of Massachusetts Medical School, Biotech 2 - 373 Plantation Street, Worcester, MA, 01605, USA.
| | - Mary M Lee
- Department of Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - NingNing Zhang
- Department of Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - Katherine Leung
- Department of Obstetrics & Gynecology, Division of Research, University of Massachusetts Medical School/UMass Memorial Health Care, Memorial Campus - 119 Belmont Street, Worcester, MA, 01605, USA.
| | - Barbara Olendzki
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - Bruce Barton
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - Milagros C Rosal
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
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Mindell JA, Sadeh A, Kwon R, Goh DYT. Relationship Between Child and Maternal Sleep: A Developmental and Cross-Cultural Comparison. J Pediatr Psychol 2015; 40:689-96. [DOI: 10.1093/jpepsy/jsv008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 01/18/2015] [Indexed: 11/13/2022] Open
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McBean AL, Montgomery-Downs HE. What are postpartum women doing while the rest of the world is asleep? J Sleep Res 2014; 24:270-8. [PMID: 25431167 DOI: 10.1111/jsr.12265] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 10/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Amanda L. McBean
- Department of Psychology; West Virginia University; Morgantown WV USA
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Longitudinal change in sleep and daytime sleepiness in postpartum women. PLoS One 2014; 9:e103513. [PMID: 25078950 PMCID: PMC4117520 DOI: 10.1371/journal.pone.0103513] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 07/03/2014] [Indexed: 12/22/2022] Open
Abstract
Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12). Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce.
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Insana SP, Craig GF, Montgomery-Downs HE. A mixed-method examination of maternal and paternal nocturnal caregiving. J Pediatr Health Care 2014; 28:313-21. [PMID: 24007974 PMCID: PMC3939069 DOI: 10.1016/j.pedhc.2013.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/12/2013] [Accepted: 07/17/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The study objectives were to describe and compare causes of, and activities during, postpartum parents' nocturnal awakenings. METHODS Twenty-one primiparous postpartum couples were studied for 1 week with qualitative and quantitative methods. RESULTS Mothers reported more awakenings per night (3.3 ± 1.1) and more wake time after going to sleep (116.0 ± 60.0 minutes) compared to fathers (2.4 ± 0.5 and 42.7 ± 39.4 minutes, respectively). "Actions taken" during maternal nocturnal awakenings were primarily for infant feeding (49.0%), general infant care (18.5%), and infant changing (12.0%). "Actions taken" during paternal nocturnal awakenings were primarily "passive awakenings" (35.9%), for self-care (18.4%), and for infant feeding (9.4%). CONCLUSIONS Qualitative analyses revealed ways that new families can optimize the sleep of both parents while also providing optimal nocturnal infant care.
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Affiliation(s)
- Salvatore P. Insana
- Department of Psychology, West Virginia University, WV, USA; Now at: Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
| | - Garfield F. Craig
- Departments of Pediatrics and Medical Social Science, Feinberg School of Medicine, Northwestern University, Chicago IL, USA
| | - Hawley E. Montgomery-Downs
- Department of Psychology, West Virginia University, WV, USA
- Correspondence concerning this article should be addressed to Hawley Montgomery-Downs: West Virginia University; Department of Psychology; PO Box 6040; 53 Campus Drive, 1124 Life Sciences Building; Morgantown, West Virginia, 26506-6040. (), Telephone: (304) 293-1761; Fax: (304) 293-6606
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Dørheim SK, Bjorvatn B, Eberhard-Gran M. Can insomnia in pregnancy predict postpartum depression? A longitudinal, population-based study. PLoS One 2014; 9:e94674. [PMID: 24732691 PMCID: PMC3986207 DOI: 10.1371/journal.pone.0094674] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/18/2014] [Indexed: 11/20/2022] Open
Abstract
Background Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. Methods A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS) was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms. Results After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours), and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS) improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. Limitations Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. Conclusions Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous depression.
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Affiliation(s)
- Signe K. Dørheim
- MoodNet Research Group, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway
- * E-mail:
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Malin Eberhard-Gran
- Health Services Research Center, Akershus University Hospital, Lørenskog, Norway
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway
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Psychiatric disorders and symptoms in children and adolescents with sleep bruxism. Sleep Breath 2013; 18:649-54. [PMID: 24371001 DOI: 10.1007/s11325-013-0928-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 09/29/2013] [Accepted: 12/09/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study examines state-trait anxiety, anxiety sensitivity (AS), depressive symptom levels, and psychiatric disorders in children and adolescents with sleep bruxism (SB). SUBJECTS AND METHOD Thirty-five patients (aged 8-17 years) with a diagnosis of SB and 35 healthy controls were included in the study. All participants were evaluated for psychiatric disorders using a structured clinical interview and completed self-report questionnaires. RESULTS At least one psychiatric disorder was present in 42.9% of the patient group and 17.1% of the control group (p < 0.05). Trait and state anxiety, anxiety sensitivity, and the severity of depression symptoms were also higher in the SB group (p < 0.05). After the multivariate analysis, the associations between state and trait anxiety, depression, and SB became statistically insignificant, while the association with anxiety sensitivity persisted. CONCLUSION This study suggests that SB is related to AS, regardless of the severity of anxiety or depressive symptoms.
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McBean AL, Montgomery-Downs HE. Timing and variability of postpartum sleep in relation to daytime performance. Physiol Behav 2013; 122:134-9. [PMID: 24041725 DOI: 10.1016/j.physbeh.2013.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 08/20/2013] [Accepted: 09/06/2013] [Indexed: 01/10/2023]
Abstract
Postpartum women have highly disturbed sleep, also known as sleep fragmentation. Fragmentation extends their total sleep period, also disrupting sleep timing. A stable and earlier sleep period among non-postpartum populations is related to better performance, physical health, and mental health. However, sleep timing has not been examined among postpartum women who are also vulnerable to daytime impairment. The study objective was to examine how the timing and regularity of sleep during the early postpartum period are related to daytime functioning across postpartum weeks 2-13. In this field-based study, 71 primiparous women wore an actigraph, a small wrist-worn device that monitors sleep and sleep timing, for the 12-week study period. Mothers self-administered a 5-min psychomotor vigilance test (PVT) each morning to evaluate the number of >500ms response lapses. They also completed a Morningness-Eveningness scale at the beginning of the study to identify chronotype. After controlling for maternal age, earlier sleep timing was associated with significantly fewer PVT lapses at postpartum weeks 9,12; a more stable sleep midpoint was associated with significantly fewer PVT lapses at postpartum weeks 2,5-13. Earlier sleep midpoints were related to more stable sleep midpoints at postpartum week 2 and a morning-type chronotype. An earlier sleep midpoint was also associated with a reduced slope of worsening PVT lapses across weeks. Across the first 12 postpartum weeks, women with earlier or more stable sleep periods had less daytime impairment than women with later or more variable sleep midpoints. Postpartum women with earlier sleep midpoints also showed less severe decrements in performance across time, which has been attributed to cumulative impacts of sleep disturbance. These data suggest that the sleep period, in addition to sleep duration and fragmentation, should be more closely examined, particularly among vulnerable women, as it may affect the neurobehavioral performance of new mothers.
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Insana SP, Williams KB, Montgomery-Downs HE. Sleep disturbance and neurobehavioral performance among postpartum women. Sleep 2013; 36:73-81. [PMID: 23288973 PMCID: PMC3524545 DOI: 10.5665/sleep.2304] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Sleep disturbances cause neurobehavioral performance and daytime functioning impairments. Postpartum women experience high levels of sleep disturbance. Thus, the study objective was to describe and explore the relation between neurobehavioral performance and sleep among women during the early postpartum period. DESIGN Longitudinal field-based study. PARTICIPANTS There were 70 primiparous women and nine nulliparous women in a control group. INTERVENTIONS None. METHODS AND RESULTS During their first 12 postpartum weeks, 70 primiparous women wore continuous wrist actigraphy to objectively monitor their sleep. Each morning they self-administered the psychomotor vigilance test (PVT) to index their neurobehavioral performance. Nine nulliparous women in a control group underwent the same protocol for 12 continuous weeks. Postpartum PVT mean reciprocal (1/RT) reaction time did not differ from that of women in the control group at postpartum week 2, but then worsened over time. Postpartum slowest 10% 1/RT PVT reaction time was significantly worse than that of women in the control group at all weeks. Despite improvements in postpartum sleep, neurobehavioral performance continued to worsen from week 2 through the end of the study. Across the first 12 postpartum weeks, PVT measures were more frequently associated with percent sleep compared with total sleep time, highlighting the deleterious consequences of sleep disruption on maternal daytime functioning throughout the early postpartum period. CONCLUSIONS Worsened maternal neurobehavioral performance across the first 12 postpartum weeks may have been influenced by the cumulative effects of sleep disturbance. These results can inform future work to identify the particular sleep profiles that could be primary intervention targets to improve daytime functioning among postpartum women, and indicate need for further research on the effectiveness of family leave policies. The time when postpartum women return to control-level daytime functioning is unknown.
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Affiliation(s)
- Salvatore P. Insana
- Department of Psychology, West Virginia University, Morgantown, WV
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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