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An Examination of Sleep as a Protective Factor for Depression and Anxiety in the Perinatal Period: Novel Causal Analyses in a Prospective Pregnancy Cohort.

Author information

Affiliations

  • 1. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
      Authors
    • Basu A 1, 3
    • Sarvet A 1
    • Zhu Y 1
    • Koenen KC 1, 3
    (4 authors)
  • 2. Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
      Authors
    • Chen JT 2
    • Denckla C 2, 3
    (2 authors)
  • 3. Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
      Authors
    • Basu A 1, 3
    • Denckla C 2, 3
    • Koenen KC 1, 3
    (3 authors)

ORCIDs linked to this article

Show all (6)

American Journal of Epidemiology, 11 Sep 2024, :kwae349
https://doi.org/10.1093/aje/kwae349 PMID: 39267220 

Abstract 

Sleep problems are common in the perinatal period. But the effects of sleep health on long-term postpartum depression and anxiety are underexamined. Using marginal structural models, we estimated the effect of sustained restful sleep quality, or adequate sleep quantity, or both, on clinically significant depression and anxiety at 23- and 32-weeks gestation, and 8-weeks, 8-, and 21-months postpartum. Women (n = 9,211) in the Avon Longitudinal Study of Parents and Children cohort reported on sleep quality (difficulty falling asleep, and early morning awakening), sleep quantity (< or > 5 hours and perceived sleep adequacy), depression (Edinburgh Postnatal Depression Scale), and anxiety (Crown-Crisp Experiential Index). Analyses adjusted for fixed (maternal education, age, body mass index, parity, marital status, smoking) and time varying (alcohol use, psychosocial adversities, depression, anxiety or sleep problems at prior time periods) covariates. Descriptive analyses suggest that sleep alterations persist beyond the immediate postpartum period. Estimates of counterfactual prevalences of outcomes under restful sleep quality and adequate sleep suggest a reduction of the population burden of clinically significant depression between 2.4% - 5.9%, and anxiety by 3.4% - 8.0% for the time points assessed. Interventions for perinatal sleep problems may reduce clinically significant depression and anxiety.

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Read article at publisher's site: https://doi.org/10.1093/aje/kwae349

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