Sleep disturbances and depressive and anxiety symptoms during pregnancy : associations with delivery and newborn health

Background Sleep disturbances and mood symptoms are common in late pregnancy; according to the literature, they can affect delivery and newborn outcomes. This study evaluated the effect of sleep and mood symptoms on delivery and newborn health, because there are insufficient and partly contradictory studies on the topic. Methods A cohort of 1414 mothers in their third trimester was enrolled in this prospective cross-sectional questionnaire study. Validated questionnaires were assessed for the measurement of sleep disturbances and depressive and anxiety symptoms. The data on delivery and newborn outcomes were obtained from hospital medical records. Results Sleep disturbances were very common. A higher insomnia score (beta = - 0.06, p = 0.047) and longer sleep need (beta = 0.07, p = 0.047) were related to delivery at a lower gestational age. In addition, a higher insomnia score (beta = - 28.30, p = 0.010) and lower general sleep quality (beta = - 62.15, p = 0.025) were associated with lower birth weight, but longer sleep duration and longer sleep need with a higher birth weight (beta = 28.06, p = 0.019; beta = 27.61, p = 0.028, respectively). However, the findings regarding birth weight lost their significance when the birth weight was standardized by gestational weeks. Concerning Apgar scores and umbilical artery pH, no associations were found. Snoring was associated with a shorter duration of the first phase of delivery (beta = - 78.71, p = 0.015) and total duration of delivery (beta = - 79.85, p = 0.016). Mothers with higher insomnia, depressive, or anxiety symptoms were more often treated with oxytocin (OR 1.54 95% CI 1.00-2.38, p = 0.049, OR 1.76, 95% CI 1.02-3.04, p = 0.049 and OR 1.91, CI 95% 1.28-2.84, p < 0.001, respectively) and those with higher depressive and anxiety symptoms were delivered more often with elective cesarean section (OR 4.67, 95% CI 2.04-12.68, p < 0.001 and OR 2.22, 95% CI 1.03-4.79, p = 0.042). Conclusions Maternal sleep disturbances and mood symptoms during pregnancy are associated with delivery and newborn health. However, nearly, all the outcomes fell within a normal range, implying that the actual risks are low.Peer reviewe

Night Awakening in Infancy : Developmental Stability and Longitudinal Associations With Psychomotor Development

Fragmented sleep is common in infancy. Although night awakening is known to decrease with age, in some infants night awakening is more persistent and continues into older ages. However, the influence of fragmented sleep on development is poorly known. In the present study, the longitudinal relationship between fragmented sleep and psychomotor development (Bayley Scales of Infant and Toddler Development [Bayley-III]; Bayley, 2009) was investigated in infants with (>= 3 night awakenings, n = 81) and without fragmented sleep (Peer reviewe

Advanced phases and reduced amplitudes are suggested to characterize the daily rest-activity cycles in depressed adolescent boys

Peer reviewe

Univaikeudet raskauden aikana - riskitekijä synnytyksen jälkeiselle masennukselle

In the general population, sleeping problems can precede an episode of depression. We hypothesized that sleeping problems during pregnancy, including insomnia symptoms, shortened sleep, and daytime tiredness, are related to maternal postnatal depressiveness. We conducted a prospective study evaluating sleep and depressive symptoms, both prenatally (around gestational week 32) and postnatally (around 3months after delivery) in the longitudinal CHILD-SLEEP birth cohort in Finland. Prenatally, 1667 women returned the questionnaire, of which 1398 women participated also at the postnatal follow-up. Sleep was measured with the Basic Nordic Sleep Questionnaire (BNSQ) and depressive symptoms with a 10-item version of the Center for Epidemiological Studies Depression Scale (CES-D). Altogether, 10.3% of the women had postnatal depressiveness (CES-D 10 points). After adjusting for main background characteristics and prenatal depressiveness (CES-D 10), poor general sleep quality (AOR 1.87, 95% CI 1.21-2.88), tiredness during the day (AOR 2.19, 95% CI 1.41-3.38), short sleep 6 and 7h, sleep latency >20min, and sleep loss 2h were associated with postnatal depressiveness (all pPeer reviewe

Portability of Polygenic Risk Scores for Sleep Duration, Insomnia and Chronotype in 33,493 Individuals

Polygenic risk scores (PRSs) estimate genetic liability for diseases and traits. However, the portability of PRSs in sleep traits has remained elusive. We generated PRSs for self-reported insomnia, chronotype and sleep duration using summary data from genome-wide association studies (GWASs) performed in 350,000 to 697,000 European-ancestry individuals. We then projected the scores in two independent Finnish population cohorts (N = 33,493) and tested whether the PRSs were associated with their respective sleep traits. We observed that all the generated PRSs were associated with their corresponding traits (p < 0.05 in all cases). Furthermore, we found that there was a 22.2 min difference in reported sleep between the 5% tails of the PRS for sleep duration (p < 0.001). Our findings indicate that sleep-related PRSs show portability across cohorts. The findings also demonstrate that sleep measures using PRSs for sleep behaviors may provide useful instruments for testing disease and trait associations in cohorts where direct sleep parameters have not yet been measured

Signaled night awakening and its association with social information processing and socio-emotional development across the first two years

Study objectives: Night awakening is common in infancy, and some infants continue to have signaled night awakenings throughout early childhood. However, the influence of signaled night awakening on children's social development is less explored. In the present study, longitudinal associations between signaled night awakening, social information processing, and socio-emotional development were measured within the CHILD-SLEEP birth cohort in two groups formed based on parent-reported night awakenings. Methods: At 8 months, there were 77 infants in the waking group (≥3 awakenings) and 69 infants in the nonwaking group (≤1 awakening). At 8 and 24 months, social information processing was measured as children's attention to neutral and emotional faces, and at 24 months, parent-reported socio-emotional behavior was measured with the Brief Infant Toddler Social Emotional Assessment (BITSEA) questionnaire. Results: The two groups showed different patterns of attention to emotional faces. The waking group had a more pronounced attentional bias to fearful vs. happy faces, whereas in the nonwaking group, attention to fearful and happy faces did not differ. In addition, at 24 months, the waking group had more dysregulation problems and lower social competence than the nonwaking group, but no clear differences in internalizing or externalizing problems were found. Conclusions: Our results contribute to the literature by showing that during the first two years of life, signaled night awakening is associated with social information processing and socio-emotional behavior.Study objectives: Night awakening is common in infancy, and some infants continue to have signaled night awakenings throughout early childhood. However, the influence of signaled night awakening on children's social development is less explored. In the present study, longitudinal associations between signaled night awakening, social information processing, and socio-emotional development were measured within the CHILD-SLEEP birth cohort in two groups formed based on parent-reported night awakenings. Methods: At 8 months, there were 77 infants in the waking group (≥3 awakenings) and 69 infants in the nonwaking group (≤1 awakening). At 8 and 24 months, social information processing was measured as children's attention to neutral and emotional faces, and at 24 months, parent-reported socio-emotional behavior was measured with the Brief Infant Toddler Social Emotional Assessment (BITSEA) questionnaire. Results: The two groups showed different patterns of attention to emotional faces. The waking group had a more pronounced attentional bias to fearful vs. happy faces, whereas in the nonwaking group, attention to fearful and happy faces did not differ. In addition, at 24 months, the waking group had more dysregulation problems and lower social competence than the nonwaking group, but no clear differences in internalizing or externalizing problems were found. Conclusions: Our results contribute to the literature by showing that during the first two years of life, signaled night awakening is associated with social information processing and socio-emotional behavior.Peer reviewe

Parent-reported early sleep problems and internalising, externalising and dysregulation symptoms in toddlers

Background The concurrence of sleep and socio-emotional development in children is well accepted. However, the predictive role of sleep problems in infancy and the development of emotional and behavioural problems later in childhood remain still unclear. Therefore, in this study we examined the associations between sleep problems in early childhood and internalising, externalising and dysregulation symptoms in toddlers. Methods 1679 families entered the study during pregnancy and 936 children participated at 24 months. Parent-reported sleep duration, sleep-onset latency, night wakings, proportion of daytime sleep and bedtime at 3, 8, 18 and 24 months were assessed with two sleep questionnaires. Externalising, internalising and dysregulation problems at 24 months were examined with the Brief Infant-Toddler Social and Emotional Assessment. Results Short sleep duration at 3 and 8 months, more night wakings at 3, 8, 18 and 24 months and greater proportion of daytime sleep at 24 months were associated with internalising symptoms. Shorter sleep duration at 8, 18 and 24 months and longer sleep-onset latency and more night wakings at all time points, in addition to earlier bedtime at 8 months and greater proportion of daytime sleep at 24 months, were related to dysregulation. Finally, more night wakings at 3 and 24 months, and longer sleep-onset latency at 24 months were associated with externalising problems. Conclusion Shorter sleep and poorer sleep quality in infancy were prospectively related to emotional and behavioural symptoms in toddlers, and these associations were strongest for internalising and dysregulation symptoms. This study contributes to the recent research on the role of early sleep problems in socio-emotional development, suggesting that shorter sleep duration, longer sleep-onset latency and higher waking frequency are related to internalising, externalising and dysregulation symptoms in toddlers, and thus it might be beneficial to provide early interventions for those infants reporting these sleep problems.Peer reviewe

Development of sleep–wake rhythms during the first year of age

First published: 08 September 201