Sleep, daily activity rhythms and postpartum mood: A longitudinal study across the perinatal period

ABSTRACT

Women with a diagnosis of bipolar and major depressive disorders are at higher risk to develop postpartum depression. The primary objective of this longitudinal study was to determine whether daily activity rhythms and sleep parameters differ between women with and without a history of a mood disorder across the perinatal period. A secondary objective was to determine whether changes in these parameters were associated with postpartum mood. In total, 33 women were included in this study, 15 of which had a history of a mood disorder (high-risk group) and 18 who did not (low-risk group). Sleep and daily rhythms were assessed subjectively and objectively during the third trimester (≥26 weeks gestation) and again at 6–12 weeks postpartum. Mood was also assessed at both time points. Women in the high-risk group showed greater subjective daily rhythms and sleep disturbances across the perinatal period. Objective sleep efficiency was worse in the high-risk group in the postpartum period. Changes in both subjective daily rhythms and objective sleep efficiency were predictive of changes in depressive symptoms across the perinatal period. These findings encourage the development of preventative therapeutics to ensure circadian rhythm and sleep stability throughout the perinatal period.

KEYWORDS:

• circadian rhythms
• depression
• mood
• postpartum
• pregnancy
• sleep

Acknowledgements

We are thankful to Dr. David L. Streiner for his statistical guidance and to Dr. Ana Paula Francisco for her editorial help. We also appreciated the support from the Community Midwives of Hamilton for their help with recruitment.

Declaration of interest

This study was supported in part by the Ontario Ministry of Research and Innovation (Early Research Award – Dr. Frey). Dr. Frey has received grant/research support from Alternative Funding Plan Innovations Award, Brain and Behavior Research Foundation, Canadian Institutes of Health Research, Hamilton Health Sciences Foundation, J.P. Bickell Foundation, Ontario Brain Institute, Ontario Mental Health Foundation, Society for Women’s Health Research, Teresa Cascioli Charitable Foundation, Eli Lilly and Pfizer, and has received consultant and/or speaker fees from AstraZeneca, Bristol-Myers Squibb, Canadian Psychiatric Association, CANMAT, Daiichi Sankyo, Lundbeck, Pfizer, Servier and Sunovion. Dr. Minuzzi has received Grants/Research Support from Alternative Funding Plan Innovations Award, Brain & Behavioral Foundation, Canadian Institutes of Health Research, Hamilton Health Sciences Foundation, Ontario Brain Institute, and Ontario Mental Health Foundation, and Speakers Bureau/Honoraria from Bristol-Myers Squibb, Lundbeck, Canadian Psychiatric Association, and the Canadian Network for Mood and Anxiety Treatments. The other authors have no conflicts to report.