Poor sleep quality increases symptoms of depression and anxiety in postpartum women

Abstract

This study evaluated the relationship between sleep quality and symptoms of depression and anxiety in women studied in pregnancy and postpartum. Scores on standardized measures of sleep (PSQI) at 6 months postpartum, and symptoms of anxiety and depression (OASIS, the PHQ9, and EPDS) were assessed by structured interviews in 116 women in pregnancy and/or postpartum. Poor sleep quality was significantly associated with greater symptoms of depression and anxiety. Women who had significantly higher OASIS (anxiety) scores (β = .530, p < .001), PHQ9 (depression) scores (β = .496, p < .001), and EPDS (postpartum depression and anxiety) scores (β = .585, p < .001) also had elevated total PSQI scores after adjustment for covariates, including prenatal depression and anxiety scores. Though inferences about causality are not feasible, these results support emerging research showing sleep quality is a risk factor for negative maternal affect in the postpartum period. Assessment of maternal sleep hygiene is worth consideration as a component of identifying women at risk for postpartum depression and anxiety.

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Fig. 1

Abbreviations

PSQI:

Pittsburgh Sleep Quality Index

PHQ9:

Patient Health Questionnaire -9-item

EPDS:

Edinburgh Postnatal Depression Scale

OASIS:

Overall Anxiety Severity and Impairment Scale

SCID:

Structured Clinical Interview for DSM-5

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Funding

NIH (R01 HD073491: MPI Coussons-Read & Dunkel Schetter).

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Correspondence to Michele L. Okun.

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Michele L. Okun, Roberta A. Mancuso, Calvin J. Hobel, Chris Dunkel Schetter and Mary Coussons-Read declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all patients for being included in the study.

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Okun, M.L., Mancuso, R.A., Hobel, C.J. et al. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. J Behav Med 41, 703–710 (2018). https://doi.org/10.1007/s10865-018-9950-7

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Keywords

  • Sleep quality
  • Depression
  • Anxiety
  • Postpartum
  • PSQI
  • EPDS