Psychological and sleep-related functioning among women with unsettled infants in Victoria, Australia: a cross-sectional study

ABSTRACT

Objective: To identify (a) clinical symptom profiles based on psychological and sleep-related functioning among women admitted to a residential early parenting service (REPS) and (b) factors associated with membership of profile groups.

Background: Depression and anxiety are common among women with unsettled infants; less is known about other indicators of psychological distress and about maternal sleep.

Methods: Women admitted to a REPS during a 5-month period completed validated measures of depression, anxiety, stress, irritability, alcohol use, fatigue, sleepiness and sleep quality. Latent class analysis was used to identify symptom profiles. Factors significantly associated with class membership were identified.

Results: Surveys were completed by 167/380 women. Scores on all measures were statistically significantly poorer than community norms. Two classes were identified, characterised by high versus low psychological distress. Mean scores on measures of fatigue, sleepiness and sleep quality were high in both classes. High psychological distress was associated with having previous mental health problems and an unmet need for emotional support.

Conclusion: Fatigue and poor sleep quality are universal among women admitted to REPS. Health services providing assistance with unsettled infant behaviour should include strategies to improve maternal sleep, and encourage social interaction among women to protect against social isolation.

KEYWORDS:

• Maternal fatigue
• unsettled infant behaviour
• residential early parenting services
• postnatal mental health

ABBREVIATIONS:

• AIC, Akaike information criterion
• AUDIT-C, Alcohol Use Disorders Identification Test – Consumption
• BIC, Bayesian information criterion
• DASS-21, Depression, Anxiety and Stress Scales
• ESS, Epworth Sleepiness Scale
• FSS, Fatigue Severity Scale
• EPC, Early Parenting Centre
• POMS, Profile of Mood States
• PSQI, Pittsburgh Sleep Quality Index
• REPS, residential early parenting service
• SAIS-6, S elf-Assessment of Irritability Scale (six items)
• VAS, Visual Analogue Fatigue Scale

Acknowledgements

The authors are very grateful to the staff at Masada Private Hospital for their collaboration in implementing this study, and to the men who contributed by participating in the study. KW was supported by a Monash University Advancing Women’s Research Success grant, NW by an Australian Government Research Training Programme Scholarship, and JF by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship, which is facilitated by a grant to the Jean Hailes Foundation from the H and L Hecht Trust managed by Perpetual Trustees.

Disclosure statement

PT is employed by Masada Private Hospital, which is owned by Ramsay Healthcare. JF receives fees from Masada Private Hospital, where she worked as a clinical psychologist, during the conduct of the study. No potential conflict of interest was reported by the other authors.