From the Biofrontiers Center (Okun) and Department of Psychology (Lac), University of Colorado Colorado Springs, Colorado Springs, Colorado.
Psychosom Med. 2023 Oct 1;85(8):736-743. doi: 10.1097/PSY.0000000000001234. Epub 2023 Jul 13.
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.
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.
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.
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.
围产期女性常报告存在失眠和睡眠质量差的问题。两者均被认为会增加产后抑郁的风险，而它们与产后焦虑的关系则知之甚少。本研究旨在评估围产期睡眠障碍是否会预测有抑郁病史的女性在产后 6 个月内每个月的抑郁和焦虑症状。
招募了在入组时无活动性抑郁的孕妇（N=159），年龄在 18 至 45 岁之间。在妊娠晚期和产后长达 6 个月的时间里，女性每月通过在线问卷完成调查，包括失眠症状问卷、匹兹堡睡眠质量指数、爱丁堡产后抑郁量表和广泛性焦虑症-7 量表。采用重复测量多层模型来预测产后的抑郁和焦虑情况。
在产后的前 6 个月中，失眠的患病率为 20.4%，睡眠质量差的患病率为 67.8%。个体间和个体内水平的产后失眠和睡眠质量差往往会独立地预测更大的抑郁和焦虑症状，即使在控制了人口统计学特征、产前失眠和产前睡眠质量差后也是如此。
我们研究样本中的大多数女性在围产期都存在睡眠障碍。与现有文献一致，产后失眠和睡眠质量差，但不是产前的睡眠指标，会纵向预测更大的产后抑郁和焦虑症状。失眠的慢性睡眠剥夺和睡眠质量差的主观体验是产后情绪障碍的独特相关风险。评估和减轻围产期睡眠障碍是减少产后情绪障碍和随后健康结果的理想机会。
