Abstract
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.
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Funding
The project was funded by the Academy of Finland (no. 134880 and 253346 TP; no. 308588 EJP, no. 277557 OSH), Gyllenberg Foundation (TP), Yrjö Jahnsson Foundation, Foundation for Pediatric Research (EJP), Finnish Cultural Foundation (EJP), the Competitive Research Financing of the Expert Responsibility area of Tampere University Hospital (OSH), Arvo ja Lea Ylppö Foundation and Doctors’ Association in Tampere (OSH), Finnish Psychiatric Association (JP), Competitive Research Financing of the Expert Responsibility area of Helsinki University Hospital (JP), and Emil Aaltonen Foundation (JP).
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EJP, TP, and OSH designed the study. JTP, EJP, and PP-K were primarily responsible for data analysis and writing of the article. OSH, TP, and PP contributed critically to the writing of the article.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Pietikäinen, J.T., Polo-Kantola, P., Pölkki, P. et al. Sleeping problems during pregnancy—a risk factor for postnatal depressiveness. Arch Womens Ment Health 22, 327–337 (2019). https://doi.org/10.1007/s00737-018-0903-5
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DOI: https://doi.org/10.1007/s00737-018-0903-5