Cox Rebecca C, Aylward Brandon S, Macarelli Isabella, Okun Michele L
Sleep, Circadian Rhythms, and Psychopathology Laboratory, Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA; Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
Happiest Baby, Inc., USA.
J Affect Disord. 2025 Nov 1;388:119523. doi: 10.1016/j.jad.2025.119523. Epub 2025 Jun 3.
Postpartum anxiety is understudied and underdiagnosed. Given associations between postpartum anxiety and adverse maternal and infant outcomes, it is crucial to identify patterns and predictors of postpartum anxiety. We examined the associations between sleep duration and timing and postpartum anxiety over 6 months following delivery.
A convenience sample of pregnant women with a history of depression (n = 162; 30-39 weeks) completed self-report measures of sleep, anxiety, and depression in the third trimester and once/month for 6 months following delivery. Concurrent and prospective associations between sleep duration, sleep timing, and postpartum anxiety symptoms were tested via 2-level multilevel models. Depression symptoms and insomnia status were included as covariates.
Clinically significant anxiety symptoms were more common than clinically significant depression symptoms at 3 out of 6 postpartum months (p's < .05). Anxiety symptoms increased over time (p < .001). Shorter month-level sleep duration was associated with higher concurrent anxiety symptoms, particularly in early postpartum months. Sleep timing was not significantly associated with concurrent anxiety symptoms (p > .05). Neither prior month sleep duration nor timing significantly predicted subsequent month anxiety symptoms (p's > .05).
Acute reduction in sleep duration may signal the presence of elevated postpartum anxiety, particularly in the early postpartum months, but may not provide predictive utility for prospective increases in anxiety from month to month. Treatments for postpartum anxiety may benefit from targeting sleep duration. Future research should replicate these findings with objective sleep measures.
产后焦虑的研究和诊断不足。鉴于产后焦虑与母婴不良结局之间的关联，识别产后焦虑的模式和预测因素至关重要。我们研究了分娩后6个月内睡眠时间和时间安排与产后焦虑之间的关联。
选取有抑郁病史的孕妇作为便利样本（n = 162；孕周30 - 39周），在孕晚期及分娩后6个月每月完成一次关于睡眠、焦虑和抑郁的自我报告测量。通过二级多水平模型检验睡眠时间、睡眠时间安排与产后焦虑症状之间的同时性和前瞻性关联。将抑郁症状和失眠状态作为协变量纳入分析。
在产后6个月中的3个月，具有临床意义的焦虑症状比具有临床意义的抑郁症状更常见（p < 0.05）。焦虑症状随时间增加（p < 0.001）。较短的月度睡眠时间与较高的同时期焦虑症状相关，尤其是在产后早期。睡眠时间安排与同时期焦虑症状无显著关联（p > 0.05）。前一个月的睡眠时间和时间安排均未显著预测随后一个月的焦虑症状（p > 0.05）。
睡眠时间的急剧减少可能预示着产后焦虑水平升高，尤其是在产后早期，但可能无法预测焦虑症状逐月的前瞻性增加。产后焦虑的治疗可能受益于针对睡眠时间的干预。未来研究应以客观睡眠测量来重复这些发现。
