Subjective perception of sleep, but not its objective quality, is associated with immediate postpartum mood disturbances in healthy women.
OBJECTIVE
This study investigated whether there was a relationship between disrupted sleep and postpartum mood disturbances in women during the week after delivery.


METHODS
Sleep and mood were measured during the third trimester (Time-1) and one week postpartum (Time-2) in a 2-stage longitudinal design.


METHODS
Participants were recruited from an antenatal clinic in a regional Melbourne hospital.


METHODS
Forty-four healthy women at low risk for postpartum depression.


METHODS
N/A.


RESULTS
Objective sleep was measured by actigraphy and subjective sleep by the Pittsburgh Sleep Quality Index; mood was assessed by the Depression Anxiety Stress Scale, the Hospital Anxiety Depression Scale, and the Positive and Negative Affect Schedule. Sleep and mood questionnaires were administered at Time-1 and Time-2. Wrist actigraphy was collected for one week at both times. After delivery, both objective and subjective nighttime sleep significantly worsened with decreased total sleep time and sleep efficiency, while daytime napping behavior significantly increased. On average, mood improved across all scales after delivery, although 45.95% of the sample experienced deterioration of mood. Regression analyses showed little relationship between Time-1 and Time-2 objective nighttime sleep, and postpartum mood. Variables that related to both Time-1 and Time-2 subjective perception of sleep, including subjective nighttime sleep, sleep-related daytime dysfunction, and daytime napping behavior, were significant predictors of postpartum mood.


CONCLUSIONS
The perception of poor sleep, and the conscious awareness of its impact during wake-time, might share a stronger relationship with the occurrence of immediate postpartum mood disturbances than actual sleep quality and quantity.
Bei
Bei
B
School of Behavioural Science, University of Melbourne, Victoria, Australia. beib@unimelb.edu.au
Milgrom
Jeannette
J
Ericksen
Jennifer
J
Trinder
John
J
D056044:Actigraphy / Q000379:methods / Q000706:statistics & numerical data; D000328:Adult; D015897:Comorbidity; D019052:Depression, Postpartum / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D010465:Perception; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
J Obstet Gynecol Neonatal Nurs. 2008 Nov-Dec;37(6):722-35; quiz 735-7
19012723
Br J Psychiatry. 1969 Aug;115(525):929-35
4308156
J Affect Disord. 2004 May;80(1):65-73
15094259
Sleep Med Rev. 2003 Aug;7(4):297-310
14505597
Aust N Z J Obstet Gynaecol. 2007 Feb;47(1):16-22
17261094
Biol Psychiatry. 1998 Jun 1;43(11):829-39
9611673
J Psychosom Res. 1998 Jul;45(1):5-13
9720850
Arch Gen Psychiatry. 1968 Jan;18(1):16-27
5634686
J Affect Disord. 1997 Feb;42(2-3):209-12
9105962
J Psychosom Res. 1992 May;36(4):309-16
1593506
Acad Med. 2006 Jan;81(1):82-5
16377826
Br J Clin Psychol. 2004 Sep;43(Pt 3):245-65
15333231
Psychiatry Res. 1989 May;28(2):193-213
2748771
Nervenarzt. 1971 Mar;42(3):117-24
5550102
Pain. 1998 Mar;75(1):75-84
9539676
J Clin Psychiatry. 2003 Oct;64(10):1195-200; quiz, 1274-6
14658968
J Psychosom Obstet Gynaecol. 2004 Sep-Dec;25(3-4):267-72
15715025
Sleep. 1994 Aug;17(5):405-8; discussion 408-10
7880249
J Pers Soc Psychol. 1988 Jun;54(6):1063-70
3397865
J Perinat Neonatal Nurs. 2007 Apr-Jun;21(2):123-9
17505232
Am J Psychiatry. 1971 Feb;127(8):1001-8
5099940
J Affect Disord. 2008 May;108(1-2):147-57
18067974
Behav Res Ther. 2007 Oct;45(10):2491-501
17583673
Am J Psychiatry. 1990 Jan;147(1):14-21
2403471
Biol Psychiatry. 1994 May 15;35(10):794-7
8043709
Sleep. 2004 Feb 1;27(1):158-65
14998254
J Psychosom Res. 2005 Jul;59(1):11-9
16126091
Sleep Med Rev. 1998 Nov;2(4):231-42
15310494
J Psychosom Res. 2002 Feb;52(2):69-77
11832252
J Psychiatry Neurosci. 2005 Jul;30(4):247-56
16049568
Aust N Z J Psychiatry. 1988 Sep;22(3):299-306
3178614
Obstet Gynecol. 2000 Jan;95(1):14-8
10636494
J Sleep Res. 2008 Jun;17(2):217-20
18482110
Sleep. 1992 Aug;15(4):293-301
1519002
J Psychosom Res. 1981;25(5):395-408
7328507
Bipolar Disord. 2003 Apr;5(2):98-105
12680898
Behav Res Ther. 2002 Aug;40(8):869-93
12186352
Br J Psychiatry. 1973 Apr;122(569):431-3
4718277
Behav Ther. 2008 Jun;39(2):171-82
18502250
Sleep. 2000 Nov 1;23(7):877-85
11083596
Pharmacoeconomics. 2005;23(9):889-912
16153133
Sleep. 2005 Jan;28(1):47-54
15700720
J Abnorm Psychol. 1990 Feb;99(1):3-15
2307763
J Adolesc Health. 1998 Nov;23(5):259-63
9814385
Acta Psychiatr Scand. 2009 Feb;119(2):128-36
18822089