title: Subjective perception of sleep, but not its objective quality, is associated with immediate postpartum mood disturbances in healthy women.
abstract: 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.
authors.affiliation: School of Behavioural Science, University of Melbourne, Victoria, Australia. beib@unimelb.edu.au
authors.forename: Bei
authors.initials: B
authors.lastname: Bei
authors.forename: Jeannette
authors.initials: J
authors.lastname: Milgrom
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ericksen
authors.forename: John
authors.initials: J
authors.lastname: Trinder
mesh_terms: 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
references.citation: J Obstet Gynecol Neonatal Nurs. 2008 Nov-Dec;37(6):722-35; quiz 735-7
references.pmid: 19012723
references.citation: Br J Psychiatry. 1969 Aug;115(525):929-35
references.pmid: 4308156
references.citation: J Affect Disord. 2004 May;80(1):65-73
references.pmid: 15094259
references.citation: Sleep Med Rev. 2003 Aug;7(4):297-310
references.pmid: 14505597
references.citation: Aust N Z J Obstet Gynaecol. 2007 Feb;47(1):16-22
references.pmid: 17261094
references.citation: Biol Psychiatry. 1998 Jun 1;43(11):829-39
references.pmid: 9611673
references.citation: J Psychosom Res. 1998 Jul;45(1):5-13
references.pmid: 9720850
references.citation: Arch Gen Psychiatry. 1968 Jan;18(1):16-27
references.pmid: 5634686
references.citation: J Affect Disord. 1997 Feb;42(2-3):209-12
references.pmid: 9105962
references.citation: J Psychosom Res. 1992 May;36(4):309-16
references.pmid: 1593506
references.citation: Acad Med. 2006 Jan;81(1):82-5
references.pmid: 16377826
references.citation: Br J Clin Psychol. 2004 Sep;43(Pt 3):245-65
references.pmid: 15333231
references.citation: Psychiatry Res. 1989 May;28(2):193-213
references.pmid: 2748771
references.citation: Nervenarzt. 1971 Mar;42(3):117-24
references.pmid: 5550102
references.citation: Pain. 1998 Mar;75(1):75-84
references.pmid: 9539676
references.citation: J Clin Psychiatry. 2003 Oct;64(10):1195-200; quiz, 1274-6
references.pmid: 14658968
references.citation: J Psychosom Obstet Gynaecol. 2004 Sep-Dec;25(3-4):267-72
references.pmid: 15715025
references.citation: Sleep. 1994 Aug;17(5):405-8; discussion 408-10
references.pmid: 7880249
references.citation: J Pers Soc Psychol. 1988 Jun;54(6):1063-70
references.pmid: 3397865
references.citation: J Perinat Neonatal Nurs. 2007 Apr-Jun;21(2):123-9
references.pmid: 17505232
references.citation: Am J Psychiatry. 1971 Feb;127(8):1001-8
references.pmid: 5099940
references.citation: J Affect Disord. 2008 May;108(1-2):147-57
references.pmid: 18067974
references.citation: Behav Res Ther. 2007 Oct;45(10):2491-501
references.pmid: 17583673
references.citation: Am J Psychiatry. 1990 Jan;147(1):14-21
references.pmid: 2403471
references.citation: Biol Psychiatry. 1994 May 15;35(10):794-7
references.pmid: 8043709
references.citation: Sleep. 2004 Feb 1;27(1):158-65
references.pmid: 14998254
references.citation: J Psychosom Res. 2005 Jul;59(1):11-9
references.pmid: 16126091
references.citation: Sleep Med Rev. 1998 Nov;2(4):231-42
references.pmid: 15310494
references.citation: J Psychosom Res. 2002 Feb;52(2):69-77
references.pmid: 11832252
references.citation: J Psychiatry Neurosci. 2005 Jul;30(4):247-56
references.pmid: 16049568
references.citation: Aust N Z J Psychiatry. 1988 Sep;22(3):299-306
references.pmid: 3178614
references.citation: Obstet Gynecol. 2000 Jan;95(1):14-8
references.pmid: 10636494
references.citation: J Sleep Res. 2008 Jun;17(2):217-20
references.pmid: 18482110
references.citation: Sleep. 1992 Aug;15(4):293-301
references.pmid: 1519002
references.citation: J Psychosom Res. 1981;25(5):395-408
references.pmid: 7328507
references.citation: Bipolar Disord. 2003 Apr;5(2):98-105
references.pmid: 12680898
references.citation: Behav Res Ther. 2002 Aug;40(8):869-93
references.pmid: 12186352
references.citation: Br J Psychiatry. 1973 Apr;122(569):431-3
references.pmid: 4718277
references.citation: Behav Ther. 2008 Jun;39(2):171-82
references.pmid: 18502250
references.citation: Sleep. 2000 Nov 1;23(7):877-85
references.pmid: 11083596
references.citation: Pharmacoeconomics. 2005;23(9):889-912
references.pmid: 16153133
references.citation: Sleep. 2005 Jan;28(1):47-54
references.pmid: 15700720
references.citation: J Abnorm Psychol. 1990 Feb;99(1):3-15
references.pmid: 2307763
references.citation: J Adolesc Health. 1998 Nov;23(5):259-63
references.pmid: 9814385
references.citation: Acta Psychiatr Scand. 2009 Feb;119(2):128-36
references.pmid: 18822089