Longitudinal Change in Sleep and Daytime Sleepiness in Postpartum Women

Abstract

Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12). Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce.

Sleep Quality and Quantity in Low-Income Postpartum Women

“…Compared to existing evidence that middle-class postpartum women sleep just over 7 hours per night with the longest episode of sleep of 4.1 hours (Filtness et al, 2014; Montgomery-Downs et al, 2010), women in our sample obtained dramatically less total sleep (5.5 hours) and the longest period of sleep was much shorter (2.8 hours). Chronic short sleep duration has significant implications to physical and mental health, functioning and performance and safety in everyday life (Watling et al, 2016).…”

“…This same study found that 46% of women napped on average for 2.2 hours per day at week 4. In another study, 44 new mothers slept on average 7.4 hours at night and the longest nighttime sleep episode was on average 4.1 hours in week 6 (Filtness, MacKenzie, & Armstrong, 2014). Both studies were conducted in women who were primarily Caucasian, middle-class, and college educated.…”

Sleep Abnormalities in Pregnancy: Review

“…One recent study suggests that over half of new mothers continue to suffer from excessive daytime sleepiness eighteen weeks after delivery, with implications for daytime functioning and timing of the return to the workforce. 46 Also, there is evidence to suggest that both pregnancy-associated and postpartum disordered sleep patterns can impact on postnatal depression. A study using wrist actigraphy to monitor poor sleep maintenance and looking at subjective assessments of sleep in twenty-five healthy primiparous women found that poor sleep maintenance was significantly associated with depression.…”

Young females at risk while driving with a small child

“…A crying infant in the vehicle might be a significant distracting factor for a mother, as the primary function of crying is to get attention from caregivers. 13 The mothers of small children may also be exposed to sleep disruption and fatigue 14,15 and preliminary results suggest that new mothers' sleep problems might be linked to a higher crash risk 16,17 . In addition, over 10% of mothers suffer from postpartum depression.…”