Maternal Sleep Health, Social Support, and Distress: A Mixed–Methods Analysis of Mothers of Infants and Young Children in Rural US

ABSTRACT

Objectives

The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population.

Methods

39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design.

Results

Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers.

Conclusions

Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.

Acknowledgments

We thank Dr. Julia Boothe, M.D., of Pickens County Primary Care, Reform, Alabama for her expertise and assistance as a community partner and Elaine Pool and Julia Tydings of the University of Alabama for their assistance in data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the College of Community Health Sciences, University of Alabama under Grant [14567]; Council on Community-Based Partnerships, University of Alabama, under the Graduate Fellowship of 2021/2022.