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Pregnancy and postpartum antidepressant use moderates the effects of sleep on depression

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Abstract

This study examined the course of antidepressant use, sleep quality, and depression severity from pregnancy through 6-month postpartum in women with and without a depressive disorder during pregnancy. Women (N = 215) were interviewed during pregnancy, 1- and 6-month postpartum. Mixed linear models were used to examine the longitudinal course and inter-relationships for the time-varying variables of antidepressant use, subjective sleep quality, and depression severity. Pregnant women with a depressive disorder who did not use antidepressants had more variable depression severity over time with improvements in depression severity by 6-month postpartum. In contrast, the depression severity of their medicated counterparts remained stable and high throughout. Pregnant women without a depressive disorder had worse sleep quality when using antidepressants compared with when they were not. Antidepressant use significantly strengthened the magnitude of the effect of sleep quality on depression severity in women with a depressive disorder during pregnancy. When prenatally depressed women use antidepressants, their sleep disturbance is more highly linked to depression severity than when they do not. Furthermore, antidepressants are not adequately treating the sleep disturbance of these women or their remitted counterparts, leaving both groups vulnerable to significant negative mental and physical health outcomes.

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Authors and Affiliations

  1. Alpert Medical School of Brown University, Box G-A1, Providence, RI, 02912, USA

    Kristen C. Stone, Amy L. Salisbury, Cynthia L. Miller-Loncar & Cynthia L. Battle

  2. Women & Infants Hospital, 101 Dudley St., Providence, RI, 02905, USA

    Kristen C. Stone, Amy L. Salisbury, Cynthia L. Miller-Loncar, Jennifer A. Mattera, Cynthia L. Battle & Dawn M. Johnsen

  3. Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, USA

    Cynthia L. Battle

  4. Department of Psychology, University of Maryland, College Park, MD, 20742, USA

    Kevin E. O’Grady

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  1. Kristen C. Stone
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  2. Amy L. Salisbury
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  3. Cynthia L. Miller-Loncar
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  4. Jennifer A. Mattera
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  5. Cynthia L. Battle
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  6. Dawn M. Johnsen
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  7. Kevin E. O’Grady
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Correspondence to Kristen C. Stone.

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Funding

This study was funded by The National Institutes of Health, grant R01MH078033 (PI: Amy Salisbury, PhD).

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The authors declare that they have no conflict of interest.

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Stone, K.C., Salisbury, A.L., Miller-Loncar, C.L. et al. Pregnancy and postpartum antidepressant use moderates the effects of sleep on depression. Arch Womens Ment Health 20, 621–632 (2017). https://doi.org/10.1007/s00737-017-0726-9

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  • DOI: https://doi.org/10.1007/s00737-017-0726-9

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