Sleep focussed interventions to improve sleep and mood in new mothers

Maternal sleep is problematic for many mothers both during pregnancy as well as postpartum and is highly associated with poor mood. This thesis provides a thorough examination of this problem as well as understanding the best methods for improving sleep and mood for new mothers. A meta-analysis was conducted to provide a quantitative analysis of nine randomised controlled trials investigating sleep-focussed interventions during pregnancy or in the first 12 months postpartum. Results indicated that interventions improve infant total sleep time but not the frequency of night-wakings. Improvements in maternal mood were also identified; however, these changes were small and possibly due to publication bias. A cluster randomised controlled trial administered during the third trimester was conducted to investigate the conditions under which a sleep focussed psychoeducation intervention is effective in improving maternal sleep and mood in the postpartum period. Two hundred and fifteen expectant first time mothers were randomised to receive either the program or a set of booklets with information about sleep. They completed questionnaires at baseline, six weeks, four months and ten months postpartum. A subgroup of participants wore actiwatches for one week during their third trimester and at four months postpartum. Results indicated that in all participants, sleep and mood worsened in the first six weeks after delivery. By four months postpartum, sleep quality and insomnia symptoms in the intervention group were significantly better than in the control group. Group differences in sleepiness, fatigue and mood were not found at any time. By ten months postpartum, differences between groups were no longer significant. These results indicate a promising role for prenatal sleep psychoeducation in hastening the return of improved maternal sleep as indicated by sleep quality and insomnia symptoms

Sleep education during pregnancy for new mothers

<p>Abstract</p> <p>Background</p> <p>There is a high association between disturbed (poor quality) sleep and depression, which has lead to a consensus that there is a bidirectional relationship between sleep and mood. One time in a woman’s life when sleep is commonly disturbed is during pregnancy and following childbirth. It has been suggested that sleep disturbance is another factor that may contribute to the propensity for women to become depressed in the postpartum period compared to other periods in their life. Post Natal Depression (PND) is common (15.5%) and associated with sleep disturbance, however, no studies have attempted to provide a sleep-focused intervention to pregnant women and assess whether this can improve sleep, and consequently maternal mood post-partum. The primary aim of this research is to determine the efficacy of a brief psychoeducational sleep intervention compared with a control group to improve sleep management, with a view to reduce depressive symptoms in first time mothers.</p> <p>Method</p> <p>This randomised controlled trial will recruit 214 first time mothers during the last trimester of their pregnancy. Participants will be randomised to receive either a set of booklets (control group) or a 3hour psychoeducational intervention that focuses on sleep. The primary outcomes of this study are sleep-related, that is sleep quality and sleepiness for ten months following the birth of the baby. The secondary outcome is depressive symptoms. It is hypothesised that participants in the intervention group will have better sleep quality and sleepiness in the postpartum period than women in the control condition. Further, we predict that women who receive the sleep intervention will have lower depression scores postpartum compared with the control group.</p> <p>Discussion</p> <p>This study aims to provide an intervention that will improve maternal sleep in the postpartum period. If sleep can be effectively improved through a brief psychoeducational program, then it may have a protective role in reducing maternal postpartum depressive symptoms.</p> <p>Registration details</p> <p>This trial is registered with the Australian New Zealand Clinical Trials Register under the registration number ACTRN12611000859987</p