title: Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period.
abstract: OBJECTIVE
  The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories.
  
  
  METHODS
  Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period.
  
  
  RESULTS
  Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period.
  
  
  CONCLUSIONS
  Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period.
authors.affiliation: Department of Psychology, University of Calgary, Calgary, AB, Canada.|Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada.|Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada.
authors.forename: Lianne M
authors.initials: LM
authors.lastname: Tomfohr
authors.affiliation: Department of Psychology, University of Calgary, Calgary, AB, Canada.
authors.forename: Elena
authors.initials: E
authors.lastname: Buliga
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Letourneau
authors.affiliation: Department of Psychology, University of Calgary, Calgary, AB, Canada.
authors.forename: Tavis S
authors.initials: TS
authors.lastname: Campbell
authors.affiliation: Department of Psychology, University of Calgary, Calgary, AB, Canada.|Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada.|Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada.
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Giesbrecht
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D001007:Anxiety / Q000150:complications; D003863:Depression / Q000150:complications; D005260:Female; D005865:Gestational Age; D006801:Humans; D049590:Postpartum Period / Q000502:physiology / Q000523:psychology; D011247:Pregnancy / Q000502:physiology* / Q000523:psychology*; D011248:Pregnancy Complications / Q000523:psychology; D012306:Risk; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology; D012944:Social Support
keywords: depression; postpartum; pregnancy; sleep; trajectories
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