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Witkowska-Zimny M, Zhyvotovska A, Isakov R, Boiko DI, Nieradko-Iwanicka B. Maternal Sleeping Problems Before and After Childbirth - A Systematic Review. Int J Womens Health 2024; 16:345-371. [PMID: 38455339 PMCID: PMC10918694 DOI: 10.2147/ijwh.s446490] [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] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/22/2024] [Indexed: 03/09/2024] Open
Abstract
The perinatal and postpartum period is of great significance for women due to physiological changes, shifts in circadian rhythms, social setting, and psychological well-being, all of which affect the quality and quantity of their sleep. A mixed-studies systematic review was undertaken to enhance our understanding of sleep disturbances and mood disorders in women in late pregnancy and the postpartum period, their connection with breastfeeding, and the assessment of interventions for sleep disturbance. Three electronic databases (PUBMED, EMBASE and Google Scholar) were searched for qualitative, observational, and mixed-method studies from the year 2016 to June 2023. Twenty-nine articles were included in the analysis. The results were synthesized into four overarching themes: (і) the sleep quality of women in the perinatal period; (ii) the relationship between sleep and breastfeeding; (iii) the relationship between sleep quality and emotional disturbance in the perinatal period; (iv) sleep interventions in the researched group. The subjective nature of the perception of sleep disturbances, along with the absence of an objective measurement tool is clearly an inconvenience. It is advisable to include the assessment of maternal sleep hygiene and family sleep patterns during postpartum healthcare provider appointments to develop strategies not only for women's sleep quality but also for their mental well-being.
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Affiliation(s)
| | - Anastasiia Zhyvotovska
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Rustam Isakov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Dmytro I Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
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Sobol M, Błachnio A, Meisner M, Szyszkowska J, Jankowski KS. Sleep, circadian activity patterns and postpartum depression: A systematic review and meta-analysis of actigraphy studies. J Sleep Res 2023. [PMID: 38095248 DOI: 10.1111/jsr.14116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/15/2023] [Accepted: 11/14/2023] [Indexed: 01/16/2024]
Abstract
Transition to motherhood is a period full of challenges and demands. In this review, we focused on the associations of sleep and circadian activity patterns during and after pregnancy with postpartum mental health factors. A systematic review and meta-analysis were conducted (PROSPERO reference 316,505). A search for articles was performed using PsycARTICLES, PsycINFO, PubMed, MEDLINE, Scopus, Cochrane, DARE, hand search, and citation tracking. The search was meant to identify peer-reviewed, experimental and observational studies reporting on women over 18 years old that assessed sleep and circadian activity patterns during pregnancy or postpartum using actigraphy, and investigated postpartum mental health factors. Nineteen relevant publications were selected. Postpartum total sleep at night was the indicator that was most closely related to the psychological functioning of women after childbirth. The results of the systematic review indicated that postpartum total sleep at night was related to postpartum fatigue, and the results of the meta-analysis suggested that total sleep at night was most strongly linked with postpartum depression. More studies are needed to estimate the associations of sleep-wake rhythm during pregnancy and in the postpartum period with postpartum mental health factors.
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Affiliation(s)
| | - Agata Błachnio
- Department of Psychology, Catholic University of Lublin, Lublin, Poland
| | - Michał Meisner
- Department of Psychology, University of Warsaw, Warsaw, Poland
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Manková D, Švancarová S, Štenclová E. Does the feeding method affect the quality of infant and maternal sleep? A systematic review. Infant Behav Dev 2023; 73:101868. [PMID: 37572515 DOI: 10.1016/j.infbeh.2023.101868] [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: 12/15/2022] [Revised: 07/01/2023] [Accepted: 07/27/2023] [Indexed: 08/14/2023]
Abstract
Breastfeeding brings many benefits to both mother and infant. Although, many women stop breastfeeding their infants too soon. The perceived association between breastfeeding and sleep may influence their decision to terminate breastfeeding. In our systematic review, we focused on mapping the relationship between infant feeding method and total sleep time (TST), number of nocturnal awakenings, awakenings after sleep onset (WASO) of mothers and infants and sleep quality of mothers. We searched four databases according to selected keywords and inclusion criteria - articles published in peer-reviewed journals between 2012 and 2022; English language; a sample consisting of mothers, infants, or both (without psychiatric and health problems); a comparison of the sleep quality of breastfed and formula-fed children or breastfeeding and formula-fed mothers. We read 260 full texts of selected articles. A total of 35 articles were included in this review. Due to significant heterogeneity, meta-analysis was not possible to accomplish. The results are processed according to narrative synthesis. Most studies agree that breastfed infants wake up more often at night. Total sleep time and time spent awake during the night (WASO) did not differ between breastfed and non-breastfed infants. We observed identical results in sleep variables among mothers. Additionally, there was no difference in maternal sleep quality. The synthesis revealed that the results may have differed due to using subjective, objective methods or the infant's age. It is important to remember that night waking is a more complex concept. Infants wake for many reasons, not just due to breastfeeding. The narrative synthesis indicated that the chosen study design, measurement method, the variables, and the infant's age could influence outcomes. In addition, other variables appeared that may affect the entire process. Therefore, we recommend that attention be paid to this in future studies.
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Affiliation(s)
- Denisa Manková
- Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic.
| | - Soňa Švancarová
- Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic
| | - Eliška Štenclová
- Department of Psychology, Faculty of Arts, Palacký University Olomouc, Czech Republic
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Okun ML, Lac A. Postpartum Insomnia and Poor Sleep Quality Are Longitudinally Predictive of Postpartum Mood Symptoms. Psychosom Med 2023; 85:736-743. [PMID: 37506301 DOI: 10.1097/psy.0000000000001234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVE Insomnia and poor sleep quality are frequently reported by perinatal women. Both are noted to increase the risk of postpartum depression, with less known about their association with postpartum anxiety. This study sought to assess whether perinatal sleep disturbances predicted depression and anxiety symptoms across each month of the first 6 months postpartum in women with a history of depression. METHODS Pregnant women without active depression at enrollment ( N = 159), 18 to 45 years of age, were recruited. In late pregnancy and for up to 6 months postpartum, women completed monthly online questionnaires including the Insomnia Symptom Questionnaire, Pittsburgh Sleep Quality Index, Edinburgh Postnatal Depression Scale, and Generalized Anxiety Disorder-7. Repeated-measures multilevel models were used to predict depression and anxiety across the postpartum. RESULTS The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Postpartum insomnia and poor sleep quality at the between-subject and within-subject levels tended to uniquely predict greater depressive and anxiety symptoms, even after controlling for demographic characteristics, prenatal insomnia, and prenatal poor sleep quality. CONCLUSIONS Most of the women in our sample had sleep disturbances across the perinatal period. Consistent with the extant literature, postpartum insomnia and poor sleep quality, but not prenatal measures of sleep, longitudinally predicted greater postpartum depression and anxiety symptoms. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant risks of postpartum mood disorders. Evaluation and mitigation of perinatal sleep disturbance are ideal opportunities to reduce postpartum mood disorders and subsequent health outcomes.
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Affiliation(s)
- Michele L Okun
- From the Biofrontiers Center (Okun) and Department of Psychology (Lac), University of Colorado Colorado Springs, Colorado Springs, Colorado
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Felder JN, Roubinov D, Zhang L, Gray M, Beck A. Endorsement of a single-item measure of sleep disturbance during pregnancy and risk for postpartum depression: a retrospective cohort study. Arch Womens Ment Health 2023; 26:67-74. [PMID: 36633715 PMCID: PMC9908713 DOI: 10.1007/s00737-022-01287-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023]
Abstract
Poor prenatal sleep quality is associated with increased risk for depressive symptoms but may go undetected in brief, busy prenatal care visits. Among non-depressed pregnant participants, we evaluated whether 1) the endorsement of sleep disturbance on a depression questionnaire predicted postpartum depressive symptoms, 2) the strength of these associations was higher than other somatic symptoms of pregnancy and depression (i.e., fatigue, appetite disturbance), and 3) the endorsement of prenatal sleep disturbance varied by participant characteristics. In this retrospective cohort study, participants had a live birth and completed Patient Health Questionnaire (PHQ-9) during pregnancy and within 8 weeks postpartum between 2012 and 2017. Participants who were non-depressed during pregnancy (PHQ-9 < 10) were included (n = 3619). We operationalized sleep disturbance, fatigue, and appetite disturbance as endorsement of item 3, 4, and 5 on the PHQ-9, respectively, and postpartum depressive symptoms as PHQ-9 total score ≥ 10. Participant characteristic variables included age, race, ethnicity, parity, gestational age at delivery, and preterm birth. Prenatal sleep disturbance was associated with higher odds of postpartum depressive symptoms (aORs 1.9, 95% CI 1.2-3.1 for first trimester; 3.7, 95% CI 1.5-11.5 for second trimester; 3.4, 95% CI 1.9-6.8 for third trimester). Fatigue and appetite disturbance in the first and third trimesters were associated with higher odds of postpartum depressive symptoms. Sleep disturbance varied by race during the first and second trimesters (p < 0.05) and was highest among Black or African American participants (61.8-65.1%). A routinely administered single-item measure of sleep disturbance could identify otherwise lower-risk pregnant individuals who may benefit from depression prevention efforts.
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Affiliation(s)
- Jennifer N. Felder
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA USA ,Osher Center for Integrative Health, University of California, San Francisco, CA USA
| | - Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA USA
| | - Li Zhang
- Department of Medicine, University of California, San Francisco, CA USA ,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Mark Gray
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO USA
| | - Arne Beck
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO USA
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Lobermeier M, Hicks A, Staples AD, Huth-Bocks AC, Warschausky S, Taylor HG, Lukomski A, Brooks J, Lajiness-O’Neill R. Longitudinal changes in term and preterm infant night wakings: The role of caregiver anxious-depression. Infant Ment Health J 2023; 44:43-53. [PMID: 36515372 PMCID: PMC9840671 DOI: 10.1002/imhj.22024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
Changes in infant night waking during the first year of life are associated with individual (e.g., prematurity) and family (e.g., caregiver psychopathology) factors. This study examined the association between infant night waking and caregiver anxious-depressive symptoms during the first year of life in preterm and term infants. We considered between-person differences and within-person changes in caregiver anxious-depressive symptoms in relation to changes in infant night waking from 2- to 9-months. Racially (30.0% Black, 60.4% White, 9.5% multiracial/other) and socioeconomically (40.0% below median household income) diverse caregivers (N = 445) of full term (n = 258) and preterm (n = 187) infants were recruited from hospitals and clinics in two midwestern states. Caregivers completed measures of anxious-depression and their infant's night waking at four sampling periods (2-, 4-, 6-, and 9-months). Infant night wakings declined from 2- to 9-months. Between-person differences were observed, such that caregivers with higher average anxious-depressive symptoms or infants born full term reported more night wakings. Within-person effects of caregiver anxious-depressive symptoms were not significant. Caregiver anxious-depression is closely associated with infant night wakings. By considering a caregiver's average severity of anxious-depression, healthcare providers can more effectively plan infant sleep interventions. If caregiver anxious-depressive symptoms are ameliorated, night wakings may also decrease.
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Affiliation(s)
| | | | | | | | | | - H. Gerry Taylor
- Case Western Reserve University/University Hospitals
- Nationwide Children’s Hospital
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Hassanzadeh R, Asghari Jafarabadi M, Mohammad-Alizadeh Charandabi S, Maghalian M, Mirghafourvand M. Psychometric properties of the Persian version of Postpartum Sleep Quality Scale. Sleep Biol Rhythms 2022; 20:569-575. [PMID: 38605813 PMCID: PMC11006641 DOI: 10.1007/s41105-022-00405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
Objective Sleep disorders are common during prenatal and postpartum periods which can be associated with physical and psychological maternal and neonatal outcomes. The aim of this study was to determine the psychometric properties of the Persian version of Postpartum Sleep Quality Scale. Methods In this study, 280 women who had given birth two to four months prior to the study were selected using cluster sampling in the year 2020. Construct validity of Postpartum Sleep Quality Scale was assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest were used to determine the reliability of the scale. Results The content validity index of the scale was 0.88 and the content validity ratio was 0.94. In the exploratory factor analysis, the single-factor structure was extracted. The fit indices confirmed the model validity. The Cronbach's alpha coefficient was 0.78 and the intra-class correlation coefficient (95% confidence interval) was 0.97 (0.94 to 0.98). The criterion validity also showed the positive correlation of the scale with the Pittsburgh Sleep Quality Index. Conclusion The present study indicates that the Persian version of Postpartum Sleep Quality Scale is a valid and reliable tool for evaluating the postpartum sleep quality in Iranian women. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00405-5.
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Affiliation(s)
- Robab Hassanzadeh
- Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
- Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Mojgan Mirghafourvand
- Social Determinants of Health Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Family Health, Social Determinants of Health Research Center, Ardabil, Iran
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Boyle JT, Rosenfield B, Di Tomasso RA, Moye J, Bamonti PM, Grandner M, Vargas I, Perlis M. Sleep Continuity, Sleep Related Daytime Dysfunction, and Problem Endorsement: Do These Vary Concordantly by Age? Behav Sleep Med 2022:1-12. [PMID: 36170023 PMCID: PMC10043048 DOI: 10.1080/15402002.2022.2124994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Sleep continuity (i.e., ability to initiate and/or maintain sleep) worsens with age. It is unclear whether problem endorsement and/or daytime dysfunction show similar age-related trends. Accordingly, a large archival dataset was used to examine age differences in sleep continuity, problem endorsement, and sleep related daytime dysfunction. METHOD Participants were categorized as: Young Adults (18-29 years); Adults (30-44 years); Middle Aged Adults (45-64 years); and Older Adults (65-89 years). Young Adults, Adults, and Middle Aged Adults were 1:1 matched with Older Adults (n = 233) on the basis of gender, race, ethnicity, and BMI. MANOVA, ANOVAs, and chi-square analysis were performed to assess for age-related differences. RESULTS In a sample of 932 adults with self-reported sleep continuity disturbance (i.e., insomnia), sleep continuity was significantly worse in older age groups. This effect was limited to middle and late insomnia with middle aged and older adults waking up with greater frequency and for longer durations of time during the night and in the early morning than younger cohorts. Problem endorsement largely increased across age groups (except for sleep latency) but reports of overall sleep-related daytime dysfunction showed no difference by age. CONCLUSION When evaluating sleep continuity disturbance, assessing whether the patient identifies their sleep continuity disturbance as a problem and whether it affects their daytime function can be informative, particularly in older adults. It may serve to reveal (case-by-case) when there are discordances between incidence/severity of illness and problem endorsement/daytime dysfunction. Such information may better inform if treatment should be initiated.
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Affiliation(s)
- Julia T Boyle
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, USA.,Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA.,New England Geriatric Research Education and Clinical Center (GRECC), Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Bradley Rosenfield
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, USA
| | - Robert A Di Tomasso
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, USA
| | - Jennifer Moye
- Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA.,New England Geriatric Research Education and Clinical Center (GRECC), Boston, Massachusetts, USA.,School of Medicine, Boston University, Boston, Massachusetts, USA.,Department of Psychology, Harvard Medical School, Boston, Massachusetts, USA
| | - Patricia M Bamonti
- Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, Arizona, USA
| | - Ivan Vargas
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Michael Perlis
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Chronobiology and Sleep Institute, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Broberg L, Damm P, Frokjaer VG, Rosthøj S, de Wolff MG, Høgh S, Tabor A, Hegaard HK. Evaluation of the Effect of Supervised Group Exercise on Self-Reported Sleep Quality in Pregnant Women with or at High Risk of Depression: A Secondary Analysis of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105954. [PMID: 35627496 PMCID: PMC9140477 DOI: 10.3390/ijerph19105954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
Poor sleep quality is common during pregnancy. Our objective was to evaluate the effect of supervised group physical exercise on self-reported sleep quality in pregnant women with or at high risk of depression, and secondly, to describe the association between sleep quality and psychological well-being during pregnancy and postpartum. This was a secondary analysis of a randomized controlled trial (n = 282) (NCT02833519) at Rigshospitalet, Denmark. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), psychological well-being by the five-item WHO Well-Being Index (WHO-5). The intention-to-treat analysis showed no difference in mean global PSQI score neither at 29−34 weeks, 6.56 (95% CI: 6.05−7.07) in the intervention group and 7.00 (95% CI: 6.47−7.53) in the control group, p = 0.2, nor at eight weeks postpartum. Women with WHO-5 ≤ 50 reported higher mean global PSQI scores at baseline, 7.82 (95% CI: 7.26−8.38), than women with WHO-5 score > 50, mean 5.42 (95% CI: 5.02−5.82), p < 0.0001. A significant difference was also present post-intervention and eight weeks postpartum. No significant effect of group exercise regarding self-reported sleep quality was seen at 29−34 weeks of gestation or postpartum. Low psychological well-being was associated with poor sleep quality during pregnancy and postpartum.
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Affiliation(s)
- Lotte Broberg
- Department of Obstetrics, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark; (P.D.); (S.H.); (H.K.H.)
- The Interdisciplinary Research Unit of Women’s, Children’s and Families’ Health, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark
- Center for Clinical Research and Prevention, Frederiksberg Hospital, 2000 Frederiksberg, Denmark
- Correspondence: ; Tel.: +45-21908188
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark; (P.D.); (S.H.); (H.K.H.)
- Department Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Vibe G. Frokjaer
- Neurobiology Research Unit, Department of Neurology, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark;
- Mental Health Services, Capital Region of Copenhagen, 2605 Brondby, Denmark
| | - Susanne Rosthøj
- Danish Cancer Society Research Center, 2100 Copenhagen, Denmark;
| | - Mie Gaarskjaer de Wolff
- Department of Obstetrics and Gynecology, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark;
| | - Stinne Høgh
- Department of Obstetrics, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark; (P.D.); (S.H.); (H.K.H.)
- Neurobiology Research Unit, Department of Neurology, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Ann Tabor
- Department Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark;
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Hanne Kristine Hegaard
- Department of Obstetrics, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark; (P.D.); (S.H.); (H.K.H.)
- The Interdisciplinary Research Unit of Women’s, Children’s and Families’ Health, Copenhagen University Hospital–Rigshospitalet, 2100 Copenhagen, Denmark
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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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Okun ML, Kohl V, Feliciano L. Comparison of longitudinal diary and actigraphy-assessed sleep in pregnant women. Sleep Med 2021; 88:149-156. [PMID: 34753041 DOI: 10.1016/j.sleep.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
STUDY OBJECTIVES Various methods are employed to assess sleep in pregnant women, including self-report, sleep diary, and actigraphy. Unfortunately, the data are often contradictory, and interpretations are often inconsistent. The current aims are to compare subjective and objective sleep data in pregnant women collected longitudinally in early pregnancy. METHODS In this secondary analysis of 104 pregnant women, sleep was collected via diary and actigraphy for 14 days during three separate occasions (10-12 weeks; 14-16 weeks; and 18-20 weeks). Sleep variables included wake after sleep onset (WASO), sleep efficiency (SE), bedtime/lights out, sleep onset latency (SL), and total sleep duration (TST). Repeated measures ANOVAs compared each sleep variable across Time and by Method of data collection, while controlling for parity and daytime naps. RESULTS Significant differences were noted for only the method of data collection for sleep component studied for WASO, F (1, 98) = 147.20, p < 0.001; SE, F (1, 98) = 129.41, p < 0.001); bedtime/lights out, F (1, 103) = 5.33, p < 0.05); and sleep duration, F (1, 104) = 182.75, p < 0.001). Significant variation was not seen in any variable across time-period. CONCLUSIONS There are substantial discrepancies between diary- and actigraphy-assessed sleep measures in pregnant women which is in alignment with previous literature. These data highlight that these methodologies assess different constructs. We contend that these data may be useful as a reference to compare high-risk women or those with sleep disorders. Using a multi-modal approach to identify sleep disturbance in pregnancy is likely a more clinically useful option.
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Affiliation(s)
- Michele L Okun
- BioFrontiers Center, University of Colorado, Colorado Springs, CO, USA; Department of Psychology, University of Colorado, Colorado Springs, CO, USA.
| | - Vanessa Kohl
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | - Leilani Feliciano
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
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12
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Yung ST, Main A, Walle EA, Scott RM, Chen Y. Associations Between Sleep and Mental Health Among Latina Adolescent Mothers: The Role of Social Support. Front Psychol 2021; 12:647544. [PMID: 34093329 PMCID: PMC8175805 DOI: 10.3389/fpsyg.2021.647544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/29/2021] [Indexed: 12/15/2022] Open
Abstract
Adolescent mothers experience poorer sleep than adult mothers, and Latina adolescent mothers are at greater risk of postpartum depression compared with other racial/ethnic groups. However, social support may be protective against the negative effects of poor sleep in this population. The current study examined (1) associations between the quality and quantity of Latina adolescent mothers’ sleep and mental health (depressive symptoms and anxiety), and (2) whether social support buffered the effects of poor sleep on mental health. A sample of Latina adolescent mothers (N = 84) from an agricultural region in the United States reported on their sleep duration/quality, social support from family, friends, and significant others, and their depressive and anxiety symptoms. Results showed that adolescent mothers reported poorer sleep than pediatric recommendations, and poorer sleep quality was associated with greater depressive and anxiety symptoms. Interestingly, when adolescent mothers reported better sleep, they had fewer depressive symptoms in the context of high support from friends compared with low support from friends. Sleep is important for mental health in Latina adolescent mothers, and better sleep combined with strong social support has positive associations with mental health in this population. Findings hold implications for improving mental health in adolescent mothers.
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Affiliation(s)
- Shun Ting Yung
- Department of Psychological Sciences, University of California, Merced, Merced, CA, United States
| | - Alexandra Main
- Department of Psychological Sciences, University of California, Merced, Merced, CA, United States
| | - Eric A Walle
- Department of Psychological Sciences, University of California, Merced, Merced, CA, United States
| | - Rose M Scott
- Department of Psychological Sciences, University of California, Merced, Merced, CA, United States
| | - Yaoyu Chen
- Department of Psychological Sciences, University of California, Merced, Merced, CA, United States
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Spaeth AM, Khetarpal R, Yu D, Pien GW, Herring SJ. Determinants of postpartum sleep duration and sleep efficiency in minority women. Sleep 2021; 44:5998103. [PMID: 33220056 DOI: 10.1093/sleep/zsaa246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/21/2020] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES To examine demographic, psychosocial, and behavioral determinants of postpartum sleep duration and sleep efficiency among a cohort of black and Latina women. METHODS Data were from 148 women (67% black, 32% Latina) at 5 months postpartum, recruited from an academic medical center in Philadelphia. Relevant demographic, psychosocial and behavioral predictors were assessed via questionnaire. Nocturnal sleep was objectively measured for 1 week using wrist actigraphy. Sleep duration was examined as a continuous variable and in categories (<7 versus ≥7 h per night); sleep efficiency was examined as a continuous variable. Independent multiple linear regression models were built to evaluate significant determinants of sleep. RESULTS Adjusted models revealed that breastfeeding, having a bedtime after midnight, and being employed were associated with shorter sleep duration (-25-33 min, all p < 0.05). Multiparity, being unmarried, being employed, breastfeeding, having a bedtime after midnight, bedsharing, and responding to infant awakenings by getting up immediately rather than waiting a few minutes to see if the infant fell back asleep, were all significant determinants of sleeping <7 h per night (OR varying: 2.29-4.59, all p < 0.05). Bedsharing was the only variable identified from the multiple regression model that associated with poorer sleep efficiency (-3.8%, p < 0.05). CONCLUSIONS Findings may inform interventions for improving postpartum sleep in socioeconomically disadvantaged, racial/ethnic minority postpartum women.
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Affiliation(s)
- Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ
| | - Risha Khetarpal
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Grace W Pien
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sharon J Herring
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA.,Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.,Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
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Ward TM, Skubic M, Rantz M, Vorderstrasse A. Human-centered approaches that integrate sensor technology across the lifespan: Opportunities and challenges. Nurs Outlook 2020; 68:734-744. [PMID: 32631796 PMCID: PMC8104265 DOI: 10.1016/j.outlook.2020.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 01/22/2023]
Abstract
Children, parents, older adults, and caregivers routinely use sensor technology as a source of health information and health monitoring. The purpose of this paper is to describe three exemplars of research that used a human-centered approach to engage participants in the development, design, and usability of interventions that integrate technology to promote health. The exemplars are based on current research studies that integrate sensor technology into pediatric, adult, and older adult populations living with a chronic health condition. Lessons learned and considerations for future studies are discussed. Nurses have successfully implemented interventions that use technology to improve health and detect, prevent, and manage diseases in children, families, individuals and communities. Nurses are key stakeholders to inform clinically relevant health monitoring that can support timely and personalized intervention and recommendations.
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Affiliation(s)
- Teresa M Ward
- School of Nursing, University of Washington, Seattle, WA.
| | - Marjorie Skubic
- Electrical Engineering and Computer Science, University of Missouri, Columbia, MO
| | - Marilyn Rantz
- Sinclair School of Nursing, University of Missouri, Columbia, MO
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General Sleep Disturbance Scale (GSDS-IT) in people with spinal cord injury: a psychometric study. Spinal Cord 2020; 58:1183-1188. [PMID: 32533045 DOI: 10.1038/s41393-020-0500-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022]
Abstract
STUDY DESIGN Psychometric study. OBJECTIVE This study sought to analyze the psychometric properties of the Italian version of the General Sleep Disturbance Scale (GSDS-IT) in a population of individuals with spinal cord injury (SCI). SETTING Italy. METHODS Its reliability was assessed using the Cronbach's alpha and intraclass correlation coefficient (ICC), while its concurrent validity was assessed using the Pearson's correlation coefficient in relation to the Pittsburgh Sleep Quality Index (PSQI). The obtained scores were compared with the cut-off score for the GSDS-IT among a healthy Italian population (38.5). RESULTS The GSDS-IT was administered to 57 participants with SCI who were recruited from all over Italy. The GSDS-IT was found to have good internal consistency (Cronbach's α of 0.76) and good test-retest reliability (ICC of 0.7), and it showed positive and significant values for all the PSQI domains. Based on the cut-off score of 38.5, 56% of participants tested positive for sleep disturbances upon admission (t0), while among the randomized participants submitted for the test-retest after 24 h (t1), 75% tested positive for sleep disturbances. CONCLUSION The GSDS-IT is a valid, reliable, and time-efficient tool for measuring sleep disturbances over the past week in a population with SCI.
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