Self-Reported Sleep Quality and Actigraphic Measures of Sleep in New Mothers and the Relationship to Postpartum Depressive Symptoms

ABSTRACT

Objective: This study’s purpose is to examine relationships between self-reported sleep quality, actigraphy data, and depressive symptoms in a sample of women at 6 and 12 weeks postpartum. Methods: This secondary analysis of data from a randomized controlled trial (RCT) of a behavioral sleep intervention measured sleep with actigraphy and self-report. Self-reported measures included the General Sleep Disturbance Scale (GSDS) and mothers’ reports of their sleep as a “small/big/no” problem. Depression was measured with the Edinburgh Postnatal Depression Scale (EPDS). Control variables included group allocation, baseline EPDS, and social support. Logistic regression estimated the association between self-reported and actigraphic measures of sleep and the presence of postpartum depressive symptoms. Separate models estimated the odds of depression according to each sleep variable. Results: In 217 first-time mothers, GSDS scores in the last week of pregnancy were not related to depression; however, GSDS scores at 6 weeks postpartum were associated with > 3 times the odds of depressive symptoms (OR = 3.56; 95% CI = 1.73–7.33) at either 6 or 12 weeks postpartum. The perception that sleep was a “small” or “big” problem at 6 weeks was associated with > 3 (OR = 3.40; 95% CI = 1.54–7.46) and > 8 (OR = 8.29; 95% CI = 2.41–28.59) times the odds of depressive symptoms at either 6 or 12 weeks, respectively. Significant associations between actigraphic sleep measures and depressive symptoms were not found. Conclusion: Self-reported sleep quality is strongly associated with postpartum depressive symptoms. Sleep concerns may be an important clinical indicator of low mood in the postpartum period. Future intervention studies to improve mood could target sleep concerns via cognitive-behavioral strategies.

Disclosure statement

No potential conflict of interest was reported by the authors.

Financial disclosure

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Nonfinancial disclosure

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Ethical approval

The Toronto Health Sciences Research Ethics Board and the two participating hospitals (St. Michael’s Hospital, Toronto, Ontario, Canada, Approval ID: REB 07-303; Sunnybrook Health Sciences Center, Toronto, Ontario, Canada, Approval ID: 371-2007). Informed consent was given by all participants.

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Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [MCT 84658]. Data were analyzed with complete independence of the researchers from the Canadian Institutes of Health Research. Robyn Stremler holds the Lawrence S. Bloomberg Limited-Term Professorship in Child and Family Health.