It should be no surprise that many women complain of disrupted sleep during pregnancy. According to a recent study, approximately 28%-38% of women meet criteria for sleep deficiency during early pregnancy. (Sleep deficiency is defined as short sleep duration, insufficient sleep, [...]
An intervention teaching new parents about normal infant sleeping and crying patterns and providing them with techniques for infant settling improves mothers' depression scores. There were no differences in scores on the Edinburgh Postnatal Depression Scale (EPDS) at 4 months, but at 6 months, caregivers in the intervention group were almost half as likely to score higher than 9 on the EPDS, with 7.9% scoring higher than 9 in the intervention group vs. 12.9% in the control cohort (adjusted odds ratio [AOR], 0.57).
Selective serotonin and serotonin-norepinephrine inhibitors (SSRIs and SNRIs) have been shown to be effective for the treatment of hot flashes. However, these agents may carry certain side effects, including sexual side effects and sleep disturbance. These two side effects may be particularly concerning to peri- and postmenopausal women who, in addition to having vasomotor symptoms, are more likely to experience sexual dysfunction and sleep disruption than premenopausal women.
The National Comorbidity Survey estimates that by the time women reach midlife, approximately 23% have experienced at least one episode of major depression and 30% have been diagnosed with an anxiety disorder. Depression and anxiety disorders are each associated with impaired functioning and lower quality of life (QOL). There is also some data to suggest that, even after a depressive episode resolves, those with a history of a affective illness have a lower quality of life than those without histories of depression, with impairment in social and interpersonal functioning.
In this randomized clinical trial, 154 sedentary, symptomatic women were randomly assigned to an aerobic training or a control group. The intervention included unsupervised aerobic training for 50 minutes four times weekly for 24 weeks, whereas the control group attended health lectures twice a month. Night sweats, mood swings, and irritability were reduced more among the women in the intervention group than in the control group.
It is estimated that up to 95% of women experience some type of sleep disturbance during pregnancy. While for many women the insomnia is relatively benign and may respond to simple interventions, other women experience more severe insomnia which has a significant impact on their quality of life and ability to function. Various non-benzodiazepine hypnotic agents, specifically zalepion (Sonata), eszopiclone (Lunesta), and zolpidem (Ambien), are commonly used for the short-term treatment of insomnia; however, information regarding the reproductive safety of these sleep aids has been sparse.
In a new mother, sleep is disrupted by repeated awakenings of the infant, but hormonal factors also seem to play a role. Immediately after childbirth, levels of the reproductive hormones, estrogen and progesterone, drop precipitously. It is believed that, because these hormones modulate neurotransmitter systems in the brain responsible for sleep quality, this dramatic hormonal shift may cause significant disruptions in sleep.
It is estimated that up to 95% of women experience some type of sleep disturbance during pregnancy. While for many women the insomnia is relatively benign and may respond to simple interventions, other women experience more severe insomnia which has a significant impact on their quality of life and ability to function. While zolpidem (Ambien), a sedative-hypnotic agent used for the short-term treatment of insomnia, is commonly prescribed in pregnant women, the information regarding its reproductive safety has been sparse.
In the July 2010 issue of Current Psychiatry, you will find a thorough review on the evaluation and treatment of insomnia in women across the life cycle. The bottom line is that many women experience insomnia during times of hormonal transition. The authors provide some useful guidelines for evaluating women who present with sleep problems (taken from Table 2):
About 15% of women suffer from depression during pregnancy, and many reports have suggested that depression during pregnancy may have negative effects on the fetus. A new study from researchers at the University of Michigan indicates a link between depression during pregnancy and infant sleep problems.
