Objective and subjective sleep during pregnancy: links with depressive and anxiety symptoms

Abstract

The aims of this paper are to study the associations between objective and subjective sleep in pregnant women, to examine which specific aspects of women's sleep are associated with depressive and anxiety symptoms and to test the moderating role of depressive and anxiety symptoms in the relations between objective and subjective sleep. The sample included 148 pregnant women. Objective sleep was measured by actigraphy for five nights at the participants' home, and subjective sleep was measured with the Pittsburgh sleep quality index. Depressive symptoms were assessed with the Edinburgh postnatal depression scale and anxiety symptoms with the Beck anxiety inventory. Significant associations were found between the subjective sleep measures and the depressive and anxiety scores, but there were no significant associations between actigraphic sleep measures and the depressive and anxiety scores. Depressive and anxiety scores emerged as significant moderators of the links between objective and subjective sleep. The findings suggest that emotional distress (i.e., depressive and anxiety symptoms severity) during pregnancy is associated with subjective sleep disturbances but not with objective sleep disturbances. Importantly, only among women with higher levels of emotional distress was subjective sleep quality associated with objective sleep quality. These findings may suggest that women with higher levels of emotional distress are not necessarily biased in their perception of sleep quality. However, they may perceive fragmented sleep as more detrimental to their wellbeing.

Maternal and paternal sleep during pregnancy in the Child-sleep birth cohort

“…It has been reported that objectively measured sleep duration deviates from that reported by more than one hour in about a third of the study participants [38]. Further, a recent study assessed sleep quality during pregnancy using both questionnaires and actigraphy [39] and found that depressiveness and anxiety were related to self-reported sleep quality but not to objective measurements of poor sleep quality. This was interpreted to suggest that women with the highest level of emotional distress perceive fragmented sleep as more detrimental to their health than the other women.…”

Determinants of sleep quality among pregnant women in China: A cross-sectional survey

“…A relationship between prenatal depression and sleep quality in pregnant women has previously been demonstrated, showing that higher levels of prenatal depression predicted poorer sleep quality, as depression is one of the main psychological factors contributing to sleep complaints [7,14,34,35]. The association between poor sleep quality and depressed mood has also been shown in epidemiologic studies of sleep in the general population [36], and with postpartum women [37,38].…”

Socio-demographic and pregnancy-related characteristics associated with prenatal distress: a Turkish study

“…One study found a correlation between the severity of insomnia in the perinatal period and depression and anxiety symptoms in women (Swanson et al, 2011). Another study found that depression and anxiety symptoms caused sleep problems throughout pregnancy (Volkovich, Tikotzky, Manber, 2016). In yet another study, results showed that pregnant women with depression had difficulty in initiating and maintaining sleep (Ruiz-Robledillo et al, 2015).…”