Sleep and Depression in Postpartum Women: A Population-Based Study

Dørheim, Signe Karen; Bondevik, Gunnar Tschudi; Eberhard‐Gran, Malin; Bjorvatn, Bjørn

doi:10.1093/sleep/32.7.847

Cited by 281 publications

(276 citation statements)

References 35 publications

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“…[8][9][10][11]13,[15][16][17]38 Although the statistic is not interpretable in our study (given the observed three-factor structure), we reported an overall Cronbach's α (0.57) so as to be consistent with the other studies. Several previous studies conducted among pregnant Australian and British women, 1,7 Norwegian postpartum women, 39 Australian adults, 40 and cancer patients in Greece 8 found that the removal of "sleep medication use" component improved the Cronbach's α for the PSQI. Jomeen et al reported that removal of this component (which was endorsed by < 3% of participants) contributed to the excellent general fit of a CFA model and recommended to remove this component from the global PSQI score calculation within the context of early pregnancy.…”

Section: Discussionmentioning

confidence: 95%

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Zhong

Gelaye

Sánchez

et al. 2015

Journal of Clinical Sleep Medicine

101

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Study Objectives: We sought to evaluate the construct validity and factor structure of the Spanish-language version of the Pittsburgh Sleep Quality Index (PSQI) among pregnant Peruvian women. Methods: A cohort of 642 women were interviewed at ≤ 16 weeks of gestation. During interview, we ascertained information about lifestyles, demographics, sleep characteristics, and mood symptoms. Stress induced sleep disturbance, depressive symptoms, and anxiety symptoms were evaluated using the Ford Insomnia Response to Stress Test (FIRST), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) assessment scales, respectively. Consistency indices, exploratory and confi rmatory factor analyses, correlations, and logistic regressions were used. Results: Both exploratory and confi rmatory factor analyses indicated a three-factor solution: sleep quality, sleep effi ciency, and sleep medication. We observed signifi cantly positive correlations of the PSQI with the FIRST (0.42), the PHQ-9 (0.49), and the GAD-7 (0.46). Poor sleepers (PSQI global score > 5) had signifi cantly increased odds of experiencing stress-induced sleep disturbance (odds ratio, OR = 3.57; 95% CI: 2.40, 5.31), depression (OR = 5.48; 95% CI: 3.58, 8.37), and generalized anxiety disorder (OR = 4.57; 95% CI: 3.08, 6.76). Conclusions:The Spanish-language version of the PSQI instrument was found to have good construct validity among pregnant Peruvian women. Consistent with some other studies, the PSQI was found to have a three-factor structure. Further assessment and validation studies are needed to determine whether the three, factor-specifi c scoring of the PSQI is favored over the PSQI global score in diverse populations. A mong pregnant women, pregnancy-associated physiological and hormonal changes are known to contribute to increased prevalence and severity of sleep complaints and disorders.1,2 Sleep complaints and disorders experienced in early pregnancy have been linked to hyperemesis, cesarean delivery, preterm birth, gestational diabetes mellitus, fetal growth restriction, and preeclampsia.2-5 Of note, an emerging literature has suggested that sleep disorders and poor sleep quality predict an increased risk of mood disorders including depressive symptomatology in late pregnancy.6,7 However, despite these observations and their clinical implications, relatively little has been done to design and implement clinical protocols that may be used to reliably and validly assess sleep effi ciency and night and daytime disturbance among pregnant women.One widely used self-reported measure of sleep quality, the Pittsburgh Sleep Quality Index (PSQI), has been established as a valid scale with acceptable psychometric properties when used among men and non-pregnant women in diverse global settings. [8][9][10][11][12][13][14][15][16][17][18] Though increasingly being used among pregnant women, 1,7,19 the psychometric properties of the PSQI has not been adequately assessed in this population. We are aware of only two published studies have eva...

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Section: Discussionmentioning

confidence: 95%

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Zhong

Gelaye

Sánchez

et al. 2015

Journal of Clinical Sleep Medicine

101

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“…Residual pain from the birth can also prevent a mother from sleeping properly, which further increases risk of postnatal depression (Dørheim et al . 2009). It is unsurprising that mothers who have a difficult birth may both find breastfeeding more difficult and be at increased risk of PND.…”

Section: Discussionmentioning

confidence: 99%

Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties

Brown

Rance

Bennett

2015

Journal of Advanced Nursing

164

128

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AimsTo examine the relationship between specific reasons for stopping breastfeeding and depressive symptoms in the postnatal period.BackgroundDifficulty breastfeeding has been connected to postnatal depression although it is unclear whether difficulty breastfeeding precedes or succeeds a diagnosis. However, the concept of ‘breastfeeding difficulty’ is wide and includes biological, psychological and social factors.DesignA cross‐sectional self‐report survey.MethodsData were collected between December 2012 and February 2013. 217 women with an infant aged 0‐6 months who had started breastfeeding at birth but had stopped before 6 months old completed a questionnaire examining breastfeeding duration and reasons for stopping breastfeeding. They further completed a copy of the Edinburgh Postnatal Depression Scale.ResultsA short breastfeeding duration and multiple reasons for stopping breastfeeding were associated with higher depression score. However, in a regression analysis only the specific reasons of stopping breastfeeding for physical difficulty and pain remained predictive of depression score.ConclusionsUnderstanding women's specific reasons for stopping breastfeeding rather than breastfeeding duration is critical in understanding women's breastfeeding experience and providing women with emotional support. Issues with pain and physical breastfeeding were most indicative of postnatal depression in comparison to psychosocial reasons highlighting the importance of spending time with new mothers to help them with issues such as latch.

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“…To place these findings into perspective, the mean global score of 6.2 and the 55% prevalence of poor sleepers were similar to those found in a study of postpartum women (median and mean infant age of approximately 8 weeks), who had a mean global score of 6.3 and a 57.7% prevalence of poor sleepers. 23 Some studies involving undergraduate students, 4,5 medical students, 13,15 and pharmacy students 19 also used the PSQI as the standard sleep scale. While all of these studies reported the percentage of poor sleepers, only 3 of them reported mean global scores, 4,15,19 and only 1 reported mean component scores.…”

Section: Discussionmentioning

confidence: 99%

Sleep Quality Among Pharmacy Students

Cates

Clark

Woolley

et al. 2015

American Journal of Pharmaceutical Education

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Objective. To determine the quality of sleep among pharmacy students in the didactic portion of the curriculum at one school of pharmacy. Methods. The study consisted of an anonymous, voluntary survey that included the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month. Results. The survey was completed by 253 students. Students in the lower grade point average (GPA) category had higher scores on 2 of 7 components of the PSQI and on the global score. Poor sleep quality, indicated by a global PSQI score of greater than 5, was reported by 140 students. The rate of poor sleeping was higher among students in the lower GPA category. Conclusion. Poor sleep quality was pervasive among surveyed pharmacy students in the didactic portion of the pharmacy school curriculum, especially among those with lower GPAs.

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Sleep and Depression in Postpartum Women: A Population-Based Study

Cited by 281 publications

References 35 publications

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties

Sleep Quality Among Pharmacy Students

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