Department of Health Solutions, National Institute for Health and Welfare, Mannerheimintie 168, P.O. Box 30, 00271, Helsinki, Finland.
Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Arch Womens Ment Health. 2019 Jun;22(3):327-337. doi: 10.1007/s00737-018-0903-5. Epub 2018 Aug 18.
In the general population, sleeping problems can precede an episode of depression. We hypothesized that sleeping problems during pregnancy, including insomnia symptoms, shortened sleep, and daytime tiredness, are related to maternal postnatal depressiveness. We conducted a prospective study evaluating sleep and depressive symptoms, both prenatally (around gestational week 32) and postnatally (around 3 months after delivery) in the longitudinal CHILD-SLEEP birth cohort in Finland. Prenatally, 1667 women returned the questionnaire, of which 1398 women participated also at the postnatal follow-up. Sleep was measured with the Basic Nordic Sleep Questionnaire (BNSQ) and depressive symptoms with a 10-item version of the Center for Epidemiological Studies Depression Scale (CES-D). Altogether, 10.3% of the women had postnatal depressiveness (CES-D ≥ 10 points). After adjusting for main background characteristics and prenatal depressiveness (CES-D ≥ 10), poor general sleep quality (AOR 1.87, 95% CI 1.21-2.88), tiredness during the day (AOR 2.19, 95% CI 1.41-3.38), short sleep ≤ 6 and ≤ 7 h, sleep latency > 20 min, and sleep loss ≥ 2 h were associated with postnatal depressiveness (all p < .050). Postnatally, after the adjustment for background characteristics, virtually all sleeping problems (i.e., difficulty falling asleep (AOR 7.93, 95% CI 4.76-13.20)), except frequent night awakenings per week or severe sleepiness during the day, were related to concurrent postnatal depressiveness. Thus, several prenatal and postnatal sleeping problems are associated with increased depressive symptoms 3 months postnatally. Screening of maternal prenatal sleeping problems, even without depressive symptoms during pregnancy or lifetime, would help to identify women at an increased risk for postnatal depressiveness.
在一般人群中，睡眠问题可能先于抑郁发作。我们假设怀孕期间的睡眠问题，包括失眠症状、睡眠时间缩短和白天疲劳，与产妇产后抑郁有关。我们在芬兰的纵向 CHILD-SLEEP 出生队列中进行了一项前瞻性研究，评估了怀孕期间（大约在妊娠第 32 周）和产后（大约在分娩后 3 个月）的睡眠和抑郁症状。在怀孕期间，有 1667 名女性返回了问卷，其中 1398 名女性也参加了产后随访。睡眠使用基本北欧睡眠问卷（BNSQ）进行测量，抑郁症状使用 10 项版流行病学研究中心抑郁量表（CES-D）进行测量。总共，10.3%的女性有产后抑郁（CES-D≥10 分）。在校正了主要背景特征和产前抑郁（CES-D≥10）后，总体睡眠质量差（OR 1.87，95%CI 1.21-2.88）、白天疲劳（OR 2.19，95%CI 1.41-3.38）、睡眠时间≤6 和≤7 小时、入睡潜伏期>20 分钟和睡眠损失≥2 小时与产后抑郁相关（均 P<.050）。产后，在校正了背景特征后，几乎所有的睡眠问题（即入睡困难（OR 7.93，95%CI 4.76-13.20）），除了每周夜间觉醒次数或白天严重嗜睡外，都与同期产后抑郁相关。因此，一些产前和产后的睡眠问题与产后 3 个月抑郁症状增加有关。筛查产妇产前睡眠问题，即使没有怀孕期间或一生中的抑郁症状，也有助于识别产后抑郁风险增加的女性。
