title: Sleep and postpartum depression.
abstract: OBJECTIVE
  The perinatal period introduces a myriad of changes. One important but often overlooked change is the increased risk for sleep disturbance. Although casually regarded as a consequence of pregnancy or postpartum, there is emerging evidence to suggest that women with significant sleep disturbance, characterized by insomnia symptoms and/or poor sleep quality, are more likely to report an increase in depressive symptomatology or develop postpartum depression (PPD). Significant consequences may arise as a result including issues with maternal-infant bonding, effective care for the infant and behavioral or emotional difficulties in the infant. This review discusses the relevant literature as to how disturbed sleep during pregnancy as well as in the postpartum may increase the risk for PPD.
  
  
  RESULTS
  Symptoms of insomnia and poor sleep quality are independently associated with greater depressive symptoms across pregnancy and throughout postpartum. Likewise, both can negatively impact the ability to mother effectively.
  
  
  CONCLUSIONS
  The presence of insomnia or sleep disturbance during the perinatal period is a risk factor for depressive symptoms. Women with depression are at an increased risk of developing sleep disturbance thereby increasing depressive symptomatology. This bidirectional and additive relationship needs more clinical attention as both sleep disturbance and depression are noted risk factors for adverse pregnancy outcomes.
authors.affiliation: University of Colorado, Colorado Springs, Colorado, USA.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Okun
mesh_terms: D019052:Depression, Postpartum / Q000150:complications*; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D012307:Risk Factors; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology; D012893:Sleep Wake Disorders / Q000523:psychology*