A Prospective Study of Sleep, Mood, and Cognitive Function in Postpartum and Nonpostpartum Women

doi:10.1016/S0029-7844(97)89252-6

Obstetrics & Gynecology

Volume 90, Issue 3, September 1997, Pages 381-386

https://doi.org/10.1016/S0029-7844(97)89252-6 Get rights and content

Abstract

Objective: To compare the sleep patterns, mood states, and cognitive functioning of primiparous mothers during the first 3 weeks postpartum with those of a control group of nonpostpartum women and to assess the relationships among these variables.

Methods: For the first 3 weeks postpartum, 30 primiparous women and 28 nonpostpartum mothers completed daily assessments of mood and recorded multiple aspects of sleep including time of retiring, occurrence and duration of sleep interruption, time of awakening, and morning alertness. Objective measures of memory, attention/concentration, and psychomotor performance were obtained on three occasions.

Results: Postpartum women reported more evening awakenings, more time awake after retiring, and more naps than controls, but overall sleep time was similar. New mothers experienced a higher level of dysphoric mood during the first week than nonpostpartum controls; however, controlling for the effect of “time awake” at night eliminated the significant effect for dysphoric mood. Few differences were observed on the multiple assessments of cognitive function; however, performances of new mothers on memory and psychomotor tasks were likely to be influenced by sleep loss.

Conclusion: Women must make important adjustments in their sleep patterns during the postpartum period. In the study group, these adjustments were largely successful, particularly after the first week postpartum, in avoiding the negative consequences of sleep disturbances such as dysphoric mood and impaired cognitive function. Nevertheless, the significant associations between sleep indices and mood and objective measures of cognitive function point to the importance of encouraging appropriate amounts of sleep for recently delivered women.

Section snippets

Materials and Methods

The subjects were 83 women, including 53 pregnant or postpartum women and 30 nonpostpartum controls. Women were informed of the study over a 16-month period by a staff nurse at a regular prenatal or gynecologic visit in the clinics of the Department of Obstetrics and Gynecology at the University of Iowa Hospitals and Clinics. Interested women were contacted by telephone by staff who explained the study and obtained informed consent. The relatively slow rate of recruiting was caused by limited

Results

New mothers were significantly younger and married for a shorter length of time than controls (P < .001, Table 1). There were no differences between postpartum and nonpostpartum women in educational background, socioeconomic status, or employment status. Demographic information was not obtained on women who dropped out from the study before the first cognitive assessment.

Seven sleep variables for each subject for each day were tabulated: time subjects initially went to sleep, time subjects

Discussion

As expected, postpartum women demonstrated more disrupted sleep during the first 3 weeks after delivery than nonpostpartum controls. Sleep variable differences between postpartum and nonpostpartum women diminished but did not disappear by 3 weeks postpartum. Although postpartum and nonpostpartum women obtained similar amounts of sleep, postpartum mothers experienced more frequent interruptions and spent more time awake during the night. They compensated for their sleep disruptions by taking

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Original ArticlesA Prospective Study of Sleep, Mood, and Cognitive Function in Postpartum and Nonpostpartum Women

Abstract

Section snippets

Materials and Methods

Results

Discussion

Am J Obstet Gynecol

Compr Psychiatry

Am J Obstet Gynecol

J Obstet Gynecol Neonatal Nurs

Appl Nurs Res

Rev Electroencephalogr Neurophysiol Clin

J Psychosom Res

J Affect Disord

Compr Psychiatry

Life Sci

Postpartum depression

A framework for the study of childbearing fatigue

Adv Nurs Sci

Current advances in theory and practice relating to postpartum syndromes

Psychiatry Med

Changes in sleep parameters of young women from late pregnancy to postpartum

J Jpn Acad Nurs Sci

Epidemiologic study of sleep disturbances and psychiatric disordersAn opportunity for prevention?

JAMA

Daytime sleepiness, performance, mood, nocturnal sleepThe effect of benzodiazepine and caffeine on their relationship

Sleep

Attention, stress, and negative emotion in persistent sleep-onset and sleep-maintenance insomnia

Sleep

Original Articles
A Prospective Study of Sleep, Mood, and Cognitive Function in Postpartum and Nonpostpartum Women