Parents’ Sleep Multi-Trajectory Modelling from 3 to 36 Months Postpartum in the SEPAGES Cohort

Figures & data

Table 1 Population Characteristics

	Mothers (N=484)				Fathers (N=410)
	Included %(N) or Mean (±SD)*(N=188)	Excluded %(N) or Mean (±SD)*(N=296)	P	Missing From Included Population	Included %(N) or Mean (±SD)*(N=188)	Excluded %(N) or Mean (±SD)*(N=222)	P-value	Missing From Included Population
Parental demographic factors
Education below bachelor level	13.9 (26)	19.3 (57)	0.12	1	17.2 (31)	21.9 (25)	0.32	8
Working during pregnancy	88.1 (163)	87.6 (226)	0.87	3	100.0 (188)	100.0 (112)	-	0
Work qualification during pregnancy			0.01	24			0.09	28
Executive or higher intellectual profession	57.3 (94)	46.1 (100)			72.5 (116)	62.4 (63)
Intermediate profession	18.3 (30)	15.2 (33)			16.3 (26)	16.8 (17)
Labourer and employee	24.4 (40)	38.7 (84)			11.3 (18)	20.8 (21)
Parental characteristics
Age at conception	32.8 (±3.5)	32.3 (±4.1)	0.11	0	35.5 (±4.2)	35.1 (±4.7)	0.55	21
Pre-conceptional BMI*	22.0 (±3.3)	22.6 (±4.1)	0.06	1	23.8 (±3.7)	24.8 (±3.5)	0.004	1
HAD* anxiety score >8 during pregnancy	32.3 (60)	33.5 (85)	0.79	2	20.7 (36)	31.1 (33)	0.05	14
HAD* depression score >8 during pregnancy	13.4 (25)	13.8 (35)	0.91	2	4.6 (8)	7.7 (8)	0.28	14
Mother smoking during pregnancy	5.6 (10)	7.6 (19)	0.40	8
C-section delivery	14.9 (28)	18.2 (53)	0.34	0
Chronotype/midsleep	3h00 (±0h36)	3h12 (±0h42)	0.17	48	3h12 (±0h42)	3h30 (±0h42)	0.04	33
Child characteristics
First child	45.2 (85)	46.6 (138)	0.76	0
Boy	55.3 (104)	52.7 (154)	0.58	0
Gestational age (weeks)	39.3 (±1.4)	39.2 (±1.7)	0.70	0
Birth weight (kg)	3.3 (±0.4)	3.3 (±0.5)	0.96	0
Childbirth seasonality			0.17	0
Spring	17.6 (33)	22.9 (67)
Summer	27.1 (51)	28.8 (84)
Autumn	34.6 (65)	25.7 (75)
Winter	20.7 (39)	22.6 (66)
Breastfeeding <26 weeks	43.7 (80)	49.6 (128)	0.22	5

*Abbreviations: %, percentage; N, number; SD, standard deviation; BMI, body mass index; HAD, Hospital Anxiety and Depression scale.

Table 2 Maternal and Paternal Sleep Characteristics at Each Time Point Postpartum (N = 188)

	Nighttime Sleep Duration		Weekend Daytime Sleep Duration				Weekday Daytime Sleep Duration		Subjective Sleep Loss
			All		Those Who Nap		Those Who Nap
	N	Mean (SD; range)	N	Mean (SD)	% (N)	Mean (SD)	% (N)	Mean (SD)	Freq % (N)
Maternal sleep characteristics
3 m	173	8h46 (1h05; 5h30–12h00)	171	0h34 (45 min)	61.0 (105)	1h02 (33 min)	15.5 (23)	0h55 (35 min)	74.6 (173)
18 m	141	8h18 (0h20; 6h24–10h39)	142	0h28 (41 min)	52.8 (75)	0h53 (34 min)	2.9 (4)	0h17 (15 min)	71.6 (141)
24 m	168	8h15 (0h48; 4h30–10h43)	164	0h29 (41 min)	53.9 (89)	1h02 (53 min)	4.2 (7)	0h35 (31 min)	62.6 (166)
36 m	181	8h16 (0h46; 5h21–11h09)	182	0h29 (38 min)	49.4 (90)	0h55 (34 min)	5.0 (9)	0h46 (59 min)	61.5 (182)
Paternal sleep characteristics
3 m	169	8h08 (0h49; 4h34 −10h00)	169	0h17 (26 min)	39.6 (67)	0h44 (23 min)	5.9 (10)	0h15 (11 min)	53.3 (169)
18 m	137	8h00 (0h42; 6h11–9h47)	134	0h19 (26 min)	43.3 (61)	0h43 (23 min)	5.8 (8)	0h23 (19 min)	50.4 (135)
24 m	167	7h59 (0h44; 4h17–9h43)	165	0h22 (31 min)	43.6 (74)	0h49 (29 min)	5.4 (9)	0h24 (22 min)	52.1 (165)
36 m	161	8h01 (0h43; 5h30–10h15)	159	0h21 (30 min)	45.3 (74)	0h47 (29 min)	8.9 (15)	0h25 (31 min)	50.6 (159)

Abbreviation: m = months.

Figure 1 Flowchart of the population.

Figure 2 Sleep multi-trajectories from 3 to 36 months postpartum in the SEPAGES cohort. (A) Maternal sleep multi-trajectories (M1-M3). 1: M1 (N=37, 19.7%), 2: M2 (N=62, 33.0%), 3: M3 (N=89, 47.3%). Lines represent mean night and weekend daytime sleep duration and subjective sleep loss trajectories. (B) Paternal sleep multi-trajectories (F1-F3). 1: F1 (N=70, 37.2%), 2: F2 (N=35, 18.6%), 3: F3 (N=83, 44.1%). Lines represent mean night and weekend daytime sleep duration and subjective sleep loss trajectories. (C) Couple sleep multi-trajectories (C1-C3). M: maternal, F: paternal, C1 (N=55, 29.2%), C2 (N=52, 27.6%) and C3 (N=81, 43.1%). Lines represent mean night and weekend daytime sleep duration and subjective sleep loss trajectories.

Table 3 Interrelations Between Maternal (M1-M3) and Paternal (F1-F3) Sleep Multi-Trajectories (N = 188 Pairs)

	Unadjusted				Adjusted^c
	M1^a	M2^a	M3^a		M1^a	M2^a	M3^a
	OR (95% CI)	OR (95% CI)	(reference)		OR (95% CI)	OR (95% CI)	(reference)
F1^b (reference)	–	–	–	F1^b (reference)	–	–	–
F2^b	1.34 (0.50–3.58)	1.06 (0.39–2.91)	–	F2^b	1.32 (0.40–4.41)	1.01 (0.32–3.22)	–
F3^b	0.32 (0.13–0.81)	1.11 (0.53–2.32)	–	F3^b	0.29 (0.10–0.80)	1.19 (0.54–2.63)	–

Notes: ᵃM1: Shortest night and DSD, and high SSL; M2: Long NSD and DSD, and highest SSL; M3: Longest NSD, moderate DSD and lowest SSL. ^bF1: Long NSD, short DSD and low SSL; F2: Shortest NSD and DSD, highest SSL; F3: Long NSD and DSD, moderate SSL. ^cAdjusted for maternal education attainment, maternal work qualification, maternal age, maternal pre-conceptional age, maternal and paternal anxiety and depression during pregnancy and maternal and paternal chronotype.

Abbreviations: NSD, nighttime sleep duration; DSD, daytime sleep duration; SSL, subjective sleep loss.

Table 4 Distribution of Maternal (M1-M3) and Paternal (F1-F3) Sleep Multi-Trajectory Groups According to Couples (C1-C3) Sleep Multi-Trajectory Groups (N = 188)

Sleep Multi-Trajectory Groups		N	Couples
			C1^a	C2^a	C3^a
			55	52	81
Maternal
	M1^b	37	39.0%	53.7%	7.3%
	M2^b	62	0.0%	35.9%	64.1%
	M3^b	89	47.0%	8.4%	44.6%
Paternal
	F1^c	70	52.9%	22.9%	24.3%
	F2^c	35	14.3%	82.9%	2.9%
	F3^c	83	15.7%	8.4%	75.9%

Notes: ᵃC1: Long NSD, short DSD and low SSL; C2: Shortest NSD and DSD, highest SSL; C3: Long NSD and DSD, moderate SSL. ^bM1: Shortest NSD and DSD, and high SSL; M2: Long NSD and DSD, and highest SSL; M3: Longest NSD, moderate DSD and lowest SSL. ^cF1: Long NSD, short DSD and low SSL; F2: Shortest NSD and DSD, highest SSL; F3: Long NSD and DSD, moderate SSL.

Abbreviations: NSD, nighttime sleep duration; DSD, daytime sleep duration; SSL, subjective sleep loss.

Table 5 Unadjusted and Adjusted Multinomial Logistic Regression for Couples Sleep Multi-Trajectory Groups (N = 188; C1 Was the Reference)

		Unadjusted Model		Adjusted Model
		C2^a (N=52)	C3^a (N=81)	C2^a (N=52)	C3^a (N=81)
		OR (95% CI)ᵇ	OR (95% CI)ᵇ	OR (95% CI)ᵇ	OR (95% CI)ᵇ
Parental demographic factors
Maternal education below bachelor level		1.43 (0.86–2.38)	0.80 (0.46–1.40)	1.98 (0.94–4.18)	0.76 (0.38–1.49)
Maternal work qualification	Executive or higher intellectual profession	Reference	Reference	Reference	Reference
	Intermediate profession	0.92 (0.44–1.94)	1.13 (0.61–2.09)	0.72 (0.30–1.77)	1.05 (0.52–2.13)
	Labourer	0.86 (0.45–1.67)	0.77 (0.44–1.36)	0.62 (0.25–1.53)	0.90 (0.45–1.80)
Parental characteristics
Maternal age		1.07 (0.96–1.19)	1.06 (0.96–1.17)	0.99 (0.85–1.15)	1.02 (0.89–1.15)
Maternal pre-conceptional BMI		1.11 (0.98–1.25)	1.04 (0.93–1.17)	1.08 (0.94–1.25)	1.07 (0.94–1.21)
Mother HAD anxiety scale>8 during pregnancy		1.27 (0.83–1.95)	1.36 (0.93–2.00)	1.20 (0.72–1.98)	1.27 (0.83–1.96)
Mother HAD depression scale>8 during pregnancy		0.93 (0.52–1.65)	1.05 (0.64–1.72)	0.67 (0.31–1.43)	0.86 (0.47–1.59)
Father HAD anxiety score >8 during pregnancy		0.97 (0.57–1.66)	1.08 (0.70–1.65)	1.08 (0.58–2.02)	1.12 (0.70–1.77)
Father HAD depression score >8 during pregnancy		1.09 (0.40–2.94)	1.35 (0.58–3.15)	1.05 (0.30–3.71)	1.29 (0.47–3.53)
Maternal chronotype		1.36 (0.69–2.69)	0.89 (0.48–1.64)	0.86 (0.29–2.53)	0.92 (0.35–2.40)
Paternal chronotype		2.42 (1.34–4.38)	0.88 (0.51–1.49)	2.86 (1.14–7.17)	0.91 (0.42–1.96)
Child characteristics
First child		0.27 (0.12–0.61)	0.56 (0.28–1.12)	0.47 (0.28–0.79)	0.77 (0.51–1.16)
Boy		1.05 (0.49–2.24)	1.24 (0.62–2.47)	0.96 (0.61–1.52)	1.07 (0.73–1.57)
Gestation age (weeks)		0.92 (0.70–1.20)	0.93 (0.73–1.19)	0.88 (0.59–1.32)	0.88 (0.63–1.24)
Birth weight (kg)		1.64 (0.64–4.21)	1.35 (0.58–3.15)	1.74 (0.41–7.46)	1.60 (0.48–5.27)
Child birth seasonality	Spring	1.31 (0.42–4.13)	1.08 (0.36–3.29)	1.21 (0.50–2.90)	0.92 (0.42–2.00)
	Summer	Reference	Reference	Reference	Reference
	Autumn	0.49 (0.19–1.29)	0.69 (0.29–1.66)	0.46 (0.22–0.96)	0.72 (0.41–1.26)
	Winter	1.09 (0.34–3.54)	1.75 (0.61–5.04)	1.99 (0.80–4.96)	1.67 (0.78–3.56)
Breastfeeding <26 weeks		0.89 (0.60–1.31)	0.92 (0.65–1.31)	0.98 (0.62–1.56)	0.97 (0.66–1.44)

Notes: ᵃC1: Long NSD, short DSD and low SSL; C2: Shortest NSD and DSD, highest SSL; C3: Long NSD and DSD, moderate SSL. ᵇOdds ratio (OR) and 95% confidence interval (95% CI).

Abbreviations: NSD, night time sleep duration; DSD, daytime sleep duration; SSL, subjective sleep loss.