Sleep Problems Common During Pregnancy, Associated with Depression

While we tend to think of sleep deprivation as a postpartum issue, a recent study from Finland indicates that sleep problems are relatively common during pregnancy, for both mothers and fathers.

This study included 1667 mothers and 1498 fathers.  The researchers evaluated the core symptoms of insomnia (sleep onset problems, nocturnal awakenings, too-early awakenings, and poor sleep quality) and, in addition, the presence of insufficient sleep, defined as a two-hour difference between self-assessed sleep need and reported sleep duration or less than six hours of sleep per night.

Symptoms of insomnia were more common among women than men (9.8% vs. 6.2%), whereas sleep insufficiency was more prevalent among men than among women (4.5% vs. 9.6%). Overall, 11.8% of the women and 14.9% of the men reported either significant insomnia or sleep insufficiency.

Symptoms of insomnia were associated with symptoms of depression both among women and men (adjusted odds ratio [AOR] = 3.8 for women vs. AOR = 1.9 in men).  Short sleep in women (but not men) was also associated with depression (AOR 3.3).

Why is This Important?

All women are at risk for depression during pregnancy and the postpartum period, and there is growing evidence to suggest that poor sleep during pregnancy and the postpartum period may be a risk factor for the development of depression. Undoubtedly the interplay between sleep and depressive symptoms is quite complex. Does sleep disruption cause depression? Or is sleep disturbance merely an early symptom of a depressive illness?

We might not fully understand this interplay, but we do know that certain techniques may be used to improve sleep quality, and there is evidence to suggest that certain interventions – using medication or non-pharmacologic strategies – can also reduce the risk and/or severity of postpartum depression.

Ruta Nonacs, MD PhD

Paavonen EJ, et al.  Maternal and paternal sleep during pregnancy in the Child-Sleep birth cohort. Sleep Med 2016.

Polo-Kantola P, Aukia L, Karlsson H, Karlsson L, Paavonen EJ.  Sleep quality during pregnancy: Associations with depressive and anxiety symptoms.  Acta Obstet Gynecol Scand. 2016 Nov 12.