Sleep and Mood During Pregnancy and the Postpartum Period

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Key points

  • Based on self-report and objective assessments, sleep is disrupted during pregnancy and the postpartum period.

  • There is strong evidence that poor self-reported sleep quality is associated with poor mood and might be a risk factor for mood problems during the perinatal period.

  • The relationship between objectively assessed sleep and mood is weaker and less consistent than the relationship between subjective sleep and mood.

  • Nonpharmacologic intervention studies have shown promise in improving

Perinatal mood disturbances

Despite commonly held beliefs of joy and happiness, women are vulnerable to mood disturbances during the perinatal period. Postpartum blues, or baby blues, is a transient form of moodiness experienced by up to 85% of new mothers 3 to 4 days after delivery, which usually dissipates within a week.1 A smaller but notable percentage of new mothers experience a major depressive disorder during pregnancy (up to 20%) or the postpartum period (about 12%–16%).2 Although postpartum blues is generally

Methods of Sleep Measurement

In this literature, sleep has been assessed by a variety of methods, each with advantages and disadvantages. Subjective measurements of sleep include self-report questionnaires, rating scales, and sleep diaries and are the most widely used methods in childbearing women. Subjective methods are nonintrusive and easy to administer. They reflect women’s overall perception rather than an accurate assessment of actual sleep.

Objective sleep assessment typically involves polysomnography (PSG) and/or

Sleep and perinatal mood disturbances

Changes in sleep during the perinatal period coincide with the occurrence of perinatal mood disturbances. Given the intimate relationship between sleep disturbances and mood in the nonpregnant population,32 several studies have assessed the impact of sleep on mood among new mothers.

Intervention studies

The increasing recognition of the impact of disrupted sleep on new mothers’ mood has encouraged intervention studies aimed to improve sleep during the perinatal period. Most of the intervention studies have targeted infant sleep through the delivery of parenting skills with the intention of improving parental sleep and well-being. For example, a randomized controlled study26 showed that reducing infant sleep problems through behavioral intervention led to significantly decreased maternal

Summary

Studies using both objective and subjective methods have confirmed that sleep is disrupted during pregnancy and postpartum periods, with pregnancy-related physical changes, childbirth, and infant care being the most significant contributing factors. The most consistent findings on pregnancy-related sleep changes are (1) a gradual decrease in TST and SE throughout pregnancy; (2) acute sleep deprivation during labor and the immediate postpartum period; and (3) continued compromise for at least 3

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