Link between insomnia and perinatal depressive symptoms: A meta‐analysis

Abstract

Evidence shows the possible link between insomnia and perinatal depressive symptoms. In order to find a convergent quantitative answer, we collected data via the search of Medline, EMBASE and reference tracking, which included nine studies (a total sample of 1,922 women). An aggregate effect size estimate (correlation coefficient) was generated using the comprehensive meta‐analysis software. For the meta‐analytic procedure, a random effects model was set a priori. Moderating factors, including study design, method of assessment of depression, geographical origin of data, publication year, mean age, % married, breastfeeding rate, quality and type of data, % primiparous and history of depression, were examined via categorical or univariate mixed‐effects (method of moments) meta‐regression methods. Heterogeneity and publication bias were examined using standard meta‐analytic approaches. We found a significant, medium‐size relationship between insomnia and perinatal depressive symptoms (point estimate, 0.366; 95% confidence interval [CI], 0.205–0.508; p < 0.001; n = 9) and this was significantly heterogeneous (Q, 118.77; df, 8; p < 0.001; I2, 93.26%). The effect size estimate was significant for studies reporting no history of depression (point estimate, 0.364; 95% CI, 0.035–0.622; p < 0.05; n = 5) and for study design. With meta‐regression, no moderating factor (age, marriage rate, breastfeeding rate, pregnancy history or publication year) significantly mediated the effect size estimate. The depression assessment scale used, but not other categorical variables, explained the magnitude of heterogeneity. We found that insomnia during the perinatal period is associated with depressive symptoms, which warrants screening pregnant mothers for insomnia and depression.

The interrelation of sleep and mental and physical health is anchored in grey-matter neuroanatomy and under genetic control

“…Our observations highlight the key relation between intelligence, mental and physical health and sleep profile in healthy subjects. Previous work has implicated the important role of sleep on life functioning, such as cognitive performance and quality of life 7,8 , as well as higher rate of depressive symptoms 13,14 , hypertension, diabetes, and obesity 25,26 . Indeed, clear associations of sleep, cognitive performance and behavioral problems have been observed in children 53 , adults 54 , and elderly 44 .…”

“…Beyond the quantity of sleep (sleep duration), quality of sleep includes sleep onset latency (i.e., time between going to bed and falling asleep), sleep efficiency (i.e., the percentage of time in bed during which someone is asleep), sleep disturbances, use of sleeping medication, and daytime dysfunction, all interacting with individual health and wellbeing 11,12 . Of note, it has been revealed that poor sleep quality is associated with higher rate of depressive symptoms in healthy subjects 13,14 ; and sleep disturbances are common in mood (e.g., major depression) and cognitive disorders 15,16 .…”

Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies

“…Due to its chronic nature, insomnia usually leads to many negative outcomes, such as impaired daily functioning, lower quality of life, and poor mental health (3,14,15). For instance, insomnia commonly occurs with psychiatric disorders, especially depression, anxiety, and psychosis (16,17). In order to reduce its adverse outcomes and allocate appropriate health resources, health professionals and policymakers need to understand the patterns and clinical features of insomnia.…”

The Correlation of Perceived Stress and Insomnia Severity in Postmenopausal Women

“…Insomnia occurs due to various causes, such as anxiety, emotional stress, and the inability to regulate emotions. On the other hand, insomnia could exacerbate stress, anxiety, and depression (9,10).…”