Lewis Beth A, Gjerdingen Dwenda, Schuver Katie, Avery Melissa, Marcus Bess H
School of Kinesiology, University of Minnesota, 1900 University Ave SE, Minneapolis, MN, 55455, USA.
Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN, 55455, USA.
BMC Womens Health. 2018 Jan 9;18(1):12. doi: 10.1186/s12905-017-0496-6.
Research indicates that poor sleep is associated with postpartum depression; however, little is known regarding this relationship among postpartum women who are at high for postpartum depression. This study examined the relationship between changes in self-reported sleep patterns (from six weeks to seven months postpartum) and depressive symptoms at seven months postpartum among women who were at high risk for postpartum depression.
Participants (n = 122) were postpartum women who were at an increased risk for postpartum depression (personal or maternal history of depression) and had participated in a randomized exercise intervention trial. For the current trial, participants completed the Pittsburgh Sleep Quality Index and Patient Health Questionnaire-9 (PHQ-9; assessed depression) at six weeks and seven months postpartum.
Overall, sleep problems significantly improved from six weeks to seven months postpartum. However, linear regression analyses indicated that worsening or minimal improvement of sleep problems were associated with higher depressive symptoms at seven month postpartum. Regarding the specific types of sleep problems, self-reported changes in sleep latency (i.e., how long it takes to fall asleep at night), daytime dysfunction (i.e., difficulty staying awake during the day), and sleep quality (i.e., subjective rating of sleep quality) were associated with higher levels of depressive symptoms.
Sleep problems typically improve during the postpartum phase. However, postpartum women who are at high risk for postpartum depression are at an increased risk for depressive symptoms later in the postpartum phase if sleep problems worsen or show only minimal improvement over time. Therefore, at the six-week postpartum clinic visit, women should receive education regarding potential worsening of sleep patterns and strategies for preventing sleep-related problems.
Registered with ClinicalTrials.gov ( NCT00961402 ) on August 18, 2009 prior to the start of the trial.
研究表明，睡眠不佳与产后抑郁症有关；然而，对于产后抑郁症风险较高的产后女性之间的这种关系，我们知之甚少。本研究调查了产后抑郁症高风险女性自我报告的睡眠模式变化（从产后六周至七个月）与产后七个月时抑郁症状之间的关系。
参与者（n = 122）为产后抑郁症风险增加的产后女性（有个人或母亲抑郁病史），她们参与了一项随机运动干预试验。在本次试验中，参与者在产后六周和七个月时完成了匹兹堡睡眠质量指数和患者健康问卷-9（PHQ-9；评估抑郁情况）。
总体而言，从产后六周至七个月，睡眠问题显著改善。然而，线性回归分析表明，睡眠问题恶化或改善甚微与产后七个月时较高的抑郁症状相关。关于睡眠问题的具体类型，自我报告的入睡潜伏期变化（即夜间入睡所需时间）、日间功能障碍（即白天难以保持清醒）和睡眠质量（即睡眠质量的主观评分）与较高水平的抑郁症状相关。
睡眠问题通常在产后阶段有所改善。然而，如果睡眠问题恶化或随时间仅显示出极小的改善，产后抑郁症高风险的产后女性在产后后期出现抑郁症状的风险会增加。因此，在产后六周的门诊就诊时，女性应接受有关睡眠模式可能恶化以及预防睡眠相关问题策略的教育。
于2009年8月18日在试验开始前在ClinicalTrials.gov（NCT00961402）注册。
