Sleep Problems During Pregnancy and Postpartum: The Roles of Social Support and Perceived Stress During Pregnancy

• In Event: The Importance of Sleep Across the Perinatal Period: Implications for Maternal and Infant Well-being

Abstract

Background. Sleep is an important factor in maintaining physical and mental health during pregnancy and postpartum, yet sleep problems are common for birthing people (Christian et al., 2019) and are linked to poor infant outcomes (Warland et al., 2018). Prenatal sleep problems often continue into postpartum as parents recover from childbirth and face significant childcare demands. Previous research suggests that sleep and depression have a bidirectional relationship, particularly during postpartum (Garfield et al., 2016), and there is evidence that women experiencing postpartum depression report the most sleep problems (Okun et al., 2018). Notably, the social support contributions of engaged partners are associated with lower depressive symptoms during pregnancy and less fatigue during postpartum (Doering et al., 2017), suggesting that social support may be a salient protective factor for postpartum sleep health. The current study examines how prenatal sleep problems, prenatal depressive symptoms, and prenatal social support interact to predict postpartum sleep problems among mothers at 16-weeks postpartum.

Methods. Participants included 54 pregnant individuals (54% white) recruited from a community sample. Mothers (as all participants identified as women) completed the MOS Social Support Scale (Sherbourne & Stewart, 1991) and Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987) at 30-weeks gestation as well as the Women’s Health Initiative Insomnia Rating Scale (WHIIRS; Levine et al., 2003) at 30-weeks gestation and 16-weeks postpartum.

Results. Linear regression analysis was used to examine the moderating roles of prenatal social support and prenatal depression on the association between prenatal sleep problems and sleep problems at 16-weeks postpartum, controlling for maternal education level. There were significant main effects of prenatal sleep problems and prenatal depressive symptoms, such that when prenatal sleep problems and depressive symptoms were high, postpartum sleep problems were also high. Although none of the two-way interactions were statistically significant, the three-way interaction was statistically significant (b = .30, SE = .14, p = .04). Follow-up conditional analyses were used to probe the interactions one standard deviation above (high) and below (low) the mean (Aiken & West, 1991). The simple slopes showed that mothers reporting high prenatal social support had relatively low levels of postpartum sleep problems even when prenatal sleep problems and depressive symptoms were high, as compared to mothers with low social support who reported higher postpartum sleep problems when prenatal sleep problems or prenatal depressive symptoms were high.

Discussion. Our findings suggest that prenatal social support is an important protective factor against postpartum sleep problems, even among women experiencing prenatal sleep difficulties and symptoms of prenatal depression. The bolstering of social support during pregnancy may be a key intervention target to improve postpartum sleep health and adjustment. Findings will be discussed in relation to types and providers of social support, as well as the importance of social support and maternal well-being for infant development.

Authors

• Gina Erato, Oklahoma State University - Stillwater
  Presenting Author

• Ashley N Quigley, Oklahoma State University - Stillwater

• Kristin Fields, Oklahoma State University - Stillwater

• Elizabeth Hinckley, Oklahoma State University - Stillwater

• Samantha Addante, Oklahoma State University - Stillwater

• Lucia Ciciolla, Oklahoma State University - Stillwater