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Changes in quality of life and sleep across the perinatal period in women with mood disorders

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Abstract

Introduction

The perinatal period represents a time of significant life changes associated with increases in sleep difficulties, depression, and potentially impaired quality of life (QoL). Associations between QoL and sleep among women with perinatal depression are poorly understood, and changes in QoL across the perinatal period have received little attention.

Methods

Participants were the treatment-as-usual group (n = 23) from a clinical trial testing an intervention for perinatal mood disorders. They completed the WHOQOL-Bref, had depression assessed with the HAM-D-17, and wore wrist actigraphs to estimate sleep for 1 week during third trimester and at 6 weeks postpartum.

Results

Higher education level was associated with better environmental QoL during pregnancy (p = .044) and presence of older children was associated with worse social QoL postpartum (p = .045). Psychological health QoL worsened (p = .014) across the perinatal period. Total sleep time (p = .001) and sleep efficiency (p = .008) decreased from third trimester to postpartum week 6, but sleep measures were not associated with QoL at either time point. Depressive symptoms decreased from pregnancy to postpartum week 6 and were inversely associated with postpartum physical and social QoL (p = .031 and .048).

Discussion

Factors contributing to self-rated QoL are variable across multiple domains during the perinatal period. QoL among our participants was lower than population norms. In our sample of women with depression and/or anxiety, QoL was related to postpartum depressive symptoms, but not to objectively measured sleep quality, quantity, or timing. Links between QoL and sleep may be inherently complex in perinatal women.

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Acknowledgements

The authors gratefully acknowledge the assistance of Julie Quattrucci, Sarah Carr, RN, Ellen Flynn, MD, Carmen Monzon, MD, Sharon Vessella, MSW, LICSW, and Bailey Driscoll. We are indebted to our colleagues who referred their patients to our study and to our participants for their commitment to this research.

Funding

Funding for this study was provided by NIH R34 MH104377 and a grant from the Seleni Institute awarded to Dr. Sharkey. The views and opinions contained within this document do not necessarily reflect those of the National Institutes of Health or the US Department of Health and Human Services and should not be construed as such. Neither of these funding sources were involved in the study design, data collection, analysis and interpretation, the writing of this report, or the decision to submit this article for publication.

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Authors and Affiliations

  1. Brown University, Providence, RI, USA

    A. W. Kang, T. B. Pearlstein & K. M. Sharkey

  2. Women’s Medicine Collaborative, Miriam Hospital, Providence, RI, USA

    T. B. Pearlstein

  3. Rhode Island Hospital, Providence, RI, USA

    K. M. Sharkey

  4. Sleep for Science Research Laboratory, 300 Duncan Drive, Providence, RI, 02906, USA

    K. M. Sharkey

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  1. A. W. Kang
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Kang, A.W., Pearlstein, T.B. & Sharkey, K.M. Changes in quality of life and sleep across the perinatal period in women with mood disorders. Qual Life Res 29, 1767–1774 (2020). https://doi.org/10.1007/s11136-020-02437-1

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