Postpartum and perinatal depression are well-known challenges for those going through pregnancy, but less focus has been given to the more common anxiety disorder.
About 15% of people experience an anxiety-related disorder during pregnancy and during the postpartum period or weeks after giving birth, along with an increased risk for symptoms of obsessive-compulsive disorder (OCD). Researchers at Washington University in St. Louis wanted to understand how sleep disruption affects all of this.
In a study recently published in Sleepthe researchers, including senior author and psychiatrist Mary Kimmel, MD, PhD, at WashU Medicine, and psychologist Rebecca Cox, PhD, at Arts & Sciences, examined about 230 women during early and late pregnancy and the early and later postpartum periods to see how sleep disturbance correlated with anxiety and OCD symptoms.
Getting full sleep can be difficult during this time, said Cox, assistant professor of psychological and brain sciences and first author of the paper. The perinatal period, which covers pregnancy until the child’s first year or two, is characterized by sleep disturbance, which can be caused by various factors such as hormonal and physical changes, as well as pregnancy-related stressors.
In the new study, the results mirror previous research suggesting that sleep problems during pregnancy are particularly pronounced in the third trimester, increase in the early postpartum period, and stabilize thereafter. But the effects of this sleep disorder on anxiety required more research.
Research participants completed various measures of sleep habits and anxiety, which included questions about “worry about the baby” or “fear of harm to the baby,” along with questions related to OCD characteristics, such as reporting thoughts such as “harmful events will happen if I’m not very careful” or “things aren’t good if they’re not perfect.”
The team also investigated how a pregnant woman’s confidence in her ability to “cope” affects this sleep and stress. Coping measures examine a person’s sense of having a situation “under control,” or their perceived ability to respond flexibly to changing demands, Cox said.
Overall, shorter sleep duration was associated with increases in perinatal anxiety and obsessive beliefs over time, the study authors found. Mothers who had more disturbed sleep, on average, had increased perinatal anxiety, and the outcome was worse for those with lower levels of coping skills.
In contrast, coping did not affect the association between sleep and obsessions. The reverse direction, anxiety and obsessions predicting less sleep, was not supported in this study, meaning that sleep loss generally precedes the arrival of anxiety-related symptoms.
The main finding suggests that shorter sleep duration is a more “strong longitudinal predictor of perinatal distress,” according to the study authors, and disturbed sleep may be a good target for perinatal mental health intervention.
The bottom line, Cox said, is “Trying to prioritize mom’s sleep can have benefits for her mental health.”
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