Submitted Successfully!
To reward your contribution, here is a gift for you: A free trial for our video production service.
Thank you for your contribution! You can also upload a video entry or images related to this topic.
Version Summary Created by Modification Content Size Created at Operation
1 -- 1043 2022-07-01 13:31:52 |
2 layout Meta information modification 1043 2022-07-04 04:17:45 |

Video Upload Options

Do you have a full video?

Confirm

Are you sure to Delete?
Cite
If you have any further questions, please contact Encyclopedia Editorial Office.
Poeira, A.F.;  Zangão, M.O. Association between Sleep Quality and Perinatal Depression. Encyclopedia. Available online: https://encyclopedia.pub/entry/24743 (accessed on 21 June 2024).
Poeira AF,  Zangão MO. Association between Sleep Quality and Perinatal Depression. Encyclopedia. Available at: https://encyclopedia.pub/entry/24743. Accessed June 21, 2024.
Poeira, Ana Filipa, Maria Otília Zangão. "Association between Sleep Quality and Perinatal Depression" Encyclopedia, https://encyclopedia.pub/entry/24743 (accessed June 21, 2024).
Poeira, A.F., & Zangão, M.O. (2022, July 01). Association between Sleep Quality and Perinatal Depression. In Encyclopedia. https://encyclopedia.pub/entry/24743
Poeira, Ana Filipa and Maria Otília Zangão. "Association between Sleep Quality and Perinatal Depression." Encyclopedia. Web. 01 July, 2022.
Association between Sleep Quality and Perinatal Depression
Edit

Pregnancy is characterized by hormonal and physiological changes; some of these changes cause changes in sleep, presenting excessive sleep in early pregnancy due to the action of progesterone, and difficulty sleeping at the end of pregnancy due to weight gain and frequency of urination. 

perinatal care depression sleep hygiene

1. Introduction

Perinatal depression is a global public health problem with an estimated prevalence of 11.9% (95% CI, 11.4–12.5) according to a metaregression that included 96 studies [1]. Although the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires that the specifier “peripartum” in depression be necessary for depression to occur during pregnancy or in the first four weeks postpartum, most experts in the field still define postpartum depression as occurring at any time in the first postpartum year regardless of the time of onset [2]. Thus, perinatal depression is defined as depressive symptoms that occur during pregnancy and those that continue or start in the first year postpartum [2]. Depression in pregnancy is highly likely to persist after childbirth if it is not diagnosed and treated on time [3]. Mood changes characterize this depressive disorder, decreased self-esteem, concentration, energy, increased tension, agitation, pessimism, guilt, ideas of self-mutilation, sleep disturbances, and weight changes [4]. Perinatal depression profoundly impacts the mother, child, and the rest of the family. For example, it has a negative effect on the child’s neurocognitive development, mainly when maternal depression occurs during the first year of life [5]. In addition, the parents’ experience causes family fractures and frustration related to what they consider to be the ideal paternity [4]. Clinically, sleep quality may be associated with an increased risk of perinatal depression [6]. Poor sleep quality is frequent during the prenatal period. In a study with 2427 pregnant women that aimed to characterize their sleep patterns and sleep problems in all months of their pregnancy, 76% of the women had poor sleep quality during pregnancy [7]. However, because sleep difficulty is assumed to be a common and temporary complication in pregnancy, few studies have effectively investigated sleep quality during pregnancy and its consequences.

2. Association between Sleep Quality and Perinatal Depression

Poor sleep quality was significantly associated with increased symptoms of depression and anxiety [8]. Studies show that sleep quality during pregnancy is associated with prenatal stress and depression [9][10][11][12]. Pregnancy is described as stressful for many women, and stress-related disorders such as insomnia and depression are highly prevalent in this period [10]. Although insomnia is considered to be an independent disorder, insomnia and depression are associated during the perinatal period [13].
Sleep quality worsens with increasing gestational and maternal age [11][14][15]. An experimental study carried out on 267 pregnant women found that pregnant women from the second half of their pregnancy onwards had higher levels of insomnia, nocturnal rumination, depression, and suicidal tendencies [10]. Sleep quality worsens as the pregnancy progresses, worsening in the last trimester [11][15]. In addition, the quality of sleep declines with increasing age [13]. In one study, pregnant women aged 30 and over were found to experience poorer sleep quality than that of pregnant women under 30. Pregnant women aged 30 or over are also more likely to experience stress and depressive symptoms during pregnancy, which probably increases the risk of postpartum depression [14].
Results indicate that poor sleep quality is expected during pregnancy [16] and may be a vital intervention target, as disturbed sleep is predictive of postpartum depression and sleep disturbances [17][18]. The meta-analysis that quantified the prevalence of poor sleep quality during pregnancy concluded that it is necessary to identify women who need treatment, and to develop and provide evidence on appropriate interventions [17]. The poor quality of prenatal sleep seems to be related to the poor quality of postnatal sleep, which can consequently increase depressive symptoms after childbirth [19]. However, few studies report on the potential role of postnatal sleep quality, and its relationship with prenatal sleep and perinatal depression [19]. Thus, future investigations should compare sleep patterns in pregnancy, and after childbirth and perinatal depression. Further studies are also necessary to understand the efficiency of exercise programs specialized for postpartum women who may be vulnerable to depression, since exercises such as Pilates improve the quality of sleep in pregnant women [20]. Women undergoing treatment for insomnia during the third trimester of pregnancy reported less symptomatology of postpartum depression than those who did not receive treatment, thus suggesting a link between sleep quality during pregnancy and perinatal depression [21]. There are also studies on mobile phone use as a strategy for treating perinatal depressive symptoms [22], which could be an advantage for rural areas with less access to health services.
Depressed pregnant women are not only underdiagnosed but also reluctant to seek help. So, it is essential to identify variables that may reveal prenatal symptoms of depression, and this can be an effective strategy to signal women who need additional care throughout the perinatal period [13]. In addition, prenatal depression is a significant risk factor for postpartum depression [23]. The association between poor sleep quality and perinatal depression leads to clinical complications, so specialist nurses in the field of maternal and obstetric health, and obstetricians should identify sleep quality in routine prenatal tests performed, thus avoiding the development of mood pathologies [9][24]. The American College of Obstetricians and Gynecologists (ACOG) recommends screening for depression and anxiety symptoms at least once during pregnancy and postpartum [25]. The literature shows that, as pregnancy progresses, sleep-related problems such as insomnia, daytime sleepiness, and poor sleep quality increase [26]. Pregnant women experience stress, anxiety, and depressive symptoms rising from 24 weeks to postpartum [27]. During regular prenatal care, signs of insomnia, difficulty in managing mental stress, and excessive preoccupation with pregnancy should be ruled out to reduce the rates of clinical depression and suicidal ideation [10]. Several studies presented the nonuse of objective measures to assess sleep quality as a limitation, so whenever possible, actigraphy should be included in the methodology of future studies [8][10][11][14][19]. The very meaning of sleep quality is still difficult to understand by subjective measures of women’s sleep quality, which often only reflect individual satisfaction with sleep [28]. Due to its severe consequences for women, children, and families, perinatal depression needs to be identified early, preferably during pregnancy or soon after childbirth, justifying the priority of screening and prevention. During pregnancy, poor sleep quality increases the risk of perinatal depression, even controlling for risk factors such as psychological distress and stress. Treatments for prenatal sleep should be explored, such as stress reduction using mindfulness and/or psychoeducational programs.

References

  1. Woody, C.A.; Ferrari, A.J.; Siskind, D.J.; Whiteford, H.A.; Harris, M.G. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J. Affect. Disord. 2017, 219, 86–92.
  2. Stuart-Parrigon, K.; Stuart, S. Perinatal depression: An update and overview. Curr. Psychiatry Rep. 2014, 16, 468.
  3. General Directorate of Health . Directorate of Psychiatry and Mental Health Services. Mental Health Promotion in Pregnancy and Early Childhood: Guidance Manual for Health Professionals; General Directorate of Health: Lisbon, Portugal, 2005.
  4. Beestin, L.; Hugh-Jones, S.; Gough, B. The impact of maternal postnatal depression on men and their ways of fathering: An interpretive phenomenological analysis. Psychol. Health 2014, 29, 717–735.
  5. Murray, L. The impact of postnatal depression on infant development. J. Child Psychol. Psychiatry 1992, 33, 543–561.
  6. Palagini, L.; Gemignani, A.; Banti, S.; Manconi, M.; Mauri, M.; Riemann, D. Chronic sleep loss during pregnancy as a determinant of stress: Impact on pregnancy outcome. Sleep Med. 2014, 15, 853–859.
  7. Mindell, J.A.; Cook, R.A.; Nikolovski, J. Sleep patterns and sleep disturbances across pregnancy. Sleep Med. 2015, 16, 483–488.
  8. Okun, M.L.; Mancuso, R.A.; Hobel, C.J.; Schetter, C.D.; Coussons-Read, M. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. J. Behav. Med. 2018, 41, 703–710.
  9. González-Mesa, E.; Cuenca-Marín, C.; Suarez-Arana, M.; Tripiana-Serrano, B.; Ibrahim-Díez, N.; Gonzalez-Cazorla, A.; Blasco-Alonso, M. Poor sleep quality is associated with perinatal depression. A systematic review of the last decade scientific literature and meta-analysis. J. Perinat. Med. 2019, 47, 689–703.
  10. Kalmbach, D.A.; Cheng, P.; Ong, J.C.; Ciesla, J.A.; Kingsberg, S.A.; Sangha, R.; Wanson, L.M.; O’Brien, L.M.; Roth, T.; Drake, C. Depression and suicidal ideation in pregnancy: Exploring relationships with insomnia, short sleep, and nocturnal rumination. Sleep Med. 2020, 65, 62–73.
  11. Polo-Kantola, P.; Aukia, L.; Karlsson, H.; Karlsson, L.; Paavonen, E.J. Sleep quality during pregnancy: Associations with depressive and anxiety symptoms. Acta Obstet. Gynecol. Scand. 2017, 96, 198–206.
  12. Eichler, J.; Schmidt, R.; Hiemisch, A.; Kiess, W.; Hilbert, A. Gestational weight gain, physical activity, sleep problems, substance use, and food intake as proximal risk factors of stress and depressive symptoms during pregnancy. BMC Pregnancy Childbirth 2019, 19, 175.
  13. Osnes, R.S.; Eberhard-Gran, M.; Follestad, T.; Kallestad, H.; Morken, G.; Roaldset, J.O. Mid-Pregnancy Insomnia and its Association with Perinatal Depressive Symptoms: A prospective cohort study. Behav. Sleep Med. 2021, 19, 285–302.
  14. Gao, M.; Hu, J.; Yang, L.; Ding, N.; Wei, X.; Li, L.; Liu, L.; Ma, Y.; Wen, D. Association of sleep quality during pregnancy with stress and depression: A prospective birth cohort study in China. BMC Pregnancy Childbirth 2019, 19, 444.
  15. Yang, Y.; Mao, J.; Ye, Z.; Zeng, X.; Zhao, H.; Liu, Y.; Li, J.; Zheng, X. Determinants of sleep quality among pregnant women in China: A cross-sectional survey. J. Matern. Fetal Neonatal Med. 2018, 31, 2980–2985.
  16. Volkovich, E.; Tikotzky, L.; Manber, R. Objective and subjective sleep during pregnancy: Links with depressive and anxiety symptoms. Arch. Womens Ment. Health 2016, 19, 173–181.
  17. Sedov, I.D.; Cameron, E.E.; Madigan, S.; Tomfohr-Madsen, L.M. Sleep quality during pregnancy: A meta-analysis. Sleep Med. Rev. 2018, 38, 168–176.
  18. Pietikäinen, J.T.; Polo-Kantola, P.; Pölkki, P.; Saarenpää-Heikkilä, O.; Paunio, T.; Paavonen, E.J. Sleeping problems during pregnancy-a risk factor for postnatal depression. Arch. Womens Ment. Health 2019, 22, 327–337.
  19. Zhou, H.; Li, W.; Ren, Y. Poor sleep quality of third trimester exacerbates the risk of experiencing postnatal depression. Psychol. Health Med. 2020, 25, 229–238.
  20. Hyun, A.-H.; Cho, J.-Y.; Koo, J.-H. Effect of Home-Based Tele-Pilates Intervention on Pregnant Women: A Pilot Study. Healthcare 2022, 10, 125.
  21. Khazaie, H.; Ghadami, M.R.; Knight, D.C.; Emamian, F.; Tahmasian, M. Insomnia treatment in the third trimester of pregnancy reduces postpartum depression symptoms: A randomized clinical trial. Psychiatry Res. 2013, 210, 901–905.
  22. Dosani, A.; Arora, H.; Mazmudar, S. mHealth and Perinatal Depression in Low-and Middle-Income Countries: A Scoping Review of the Literature. Int. J. Environ. Res. Public Health 2020, 17, 7679.
  23. Wisner, K.L.; Sit, D.K.Y.; McShea, M.C.; Rizzo, D.M.; Zoretich, R.A.; Hughes, C.L.; Eng, H.F.; Luther, J.F.; Wisniewski, S.; Costantino, M.L.; et al. Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings. JAMA Psychiatry 2013, 70, 490–498.
  24. Kempler, L.; Sharpe, L.A.; Marshall, N.S.; Bartlett, D.J. A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: A randomized controlled trial. Sleep 2020, 43, zsaa101.
  25. ACOG Committee. ACOG Committee Opinion No. 757: Screening for perinatal depression. Obstet. Gynecol. 2018, 132, e208–e212.
  26. Warland, J.; Dorrian, J.; Morrison, J.L.; O’Brien, L.M. Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis. Sleep Med. Rev. 2018, 41, 197–219.
  27. Cheng, C.-Y.; Chou, Y.-H.; Chang, C.-H.; Liou, S.-R. Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression. Int. J. Environ. Res. Public Health 2021, 18, 9307.
  28. Ohayon, M.; Wickwire, E.M.; Hirshkowitz, M.; Albert, S.M.; Avidan, A.; Daly, F.J.; Dauvilliers, Y.; Ferri, R.; Fung, C.; Gozal, D.; et al. National Sleep Foundation’s sleep quality recommendations: First report. Sleep Health 2017, 3, 6–19.
More
Information
Subjects: Nursing
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register : ,
View Times: 315
Revisions: 2 times (View History)
Update Date: 04 Jul 2022
1000/1000
Video Production Service