Dynamic Associations Among Sleep, Emotion Dysregulation, and Desire to Live in a Perinatal Sample

Abstract

Objective The present study prospectively examined dynamic associations among sleep, emotion dysregulation, and desire to live during the perinatal transition, as it was theorized that these factors may contribute to the emergence of postpartum suicide risk. Method Ninety-four women (M age = 29.2 years; 23.4% Latina) wore wrist actigraphs and completed twice daily surveys for 7 days during the 3rd trimester of pregnancy, 6 weeks postpartum, and 4 months postpartum. Multilevel, change-as-outcome models were built to examine changes in attractor dynamics among sleep, emotion dysregulation, and desire to live, as well as if sleep-emotion dysregulation dynamics differed based on participants’ desires to live. Results From pregnancy to 6 weeks postpartum, emotion dysregulation (B = -.09, p = .032) and desire to live (B = -.16, p < .001) exhibited more stable temporal patterns around higher emotion dysregulation and lower desire to live. Compared to women who reported consistently high desires to live, those who experienced fluctuations in their desires to live exhibited lower, more stable sleep efficiency during pregnancy (B = -.90, p < .001). At 4 months postpartum, those with fluctuating desires to live exhibited a coupling dynamic whereby low sleep efficiency predicted increases in emotion dysregulation (B = -.16, p = .020). Conclusion This study was the first to examine nonlinear dynamics among risk factors for postpartum suicide, which may be evident as early as pregnancy and 6 weeks postpartum. Sleep health, in particular, warrants further exploration as a key susceptibility factor in the emergence of postpartum suicide risk. Preregistration: Open Science Framework (https://osf.io/qxb75/?view_only=799ffe5c048842dfb89d3ddfebaa420d)

Exploring the Interplay Between Stress, Sleep, and Health: A Special Issue Commemorating the Contributions of Dr. Martica Hall

“…These articles cover a wide range of topics, methodologies, and populations that collectively demonstrate the widespread impact of stress and sleep on health. We believe Tica would have been pleased to see a single issue addressing topics as diverse as the impact of sleep on cardiovascular health in physicians experiencing burnout (1); the role of biobehavioral rhythm stability in predicting the metabolic syndrome (2); dyadic sleep influences on posttraumatic symptoms among cancer patients and their caregivers (3); and prospective, often bidirectional associations between sleep and psychosocial factors (4–6) and mental health (7,8). Several articles also highlight the dynamic nature of sleep during critical periods across the life span (9) and multidimensional conceptualizations of sleep health (10), ideas and methodologies championed by Tica.…”