Relationships Among Depression, Anxiety, and Insomnia Symptoms in Perinatal Women Seeking Mental Health Treatment

Swanson, Leslie M.; Pickett, Scott M.; Flynn, Heather A.; Armitage, Roseanne

doi:10.1089/jwh.2010.2371

Cited by 120 publications

(87 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The observed rate of clinically significant insomnia in the presence of a high level of depressive symptom severity (46.7%) is comparable to that reported by Swanson et al, 59 who found that 45% of pregnant women in a universityaffiliated outpatient psychiatry clinic had clinically significant insomnia, which the researchers defined as ISI scores above 14. At the same time, the observed rate of clinically significant insomnia among pregnant women with low depression scores (8%) in our study was similar to rates observed in the general population.…”

Section: Discussionsupporting

confidence: 82%

Factors Associated with Clinically Significant Insomnia Among Pregnant Low-Income Latinas

Manber

Steidtmann

Chambers

et al. 2013

Journal of Women's Health

View full text Add to dashboard Cite

Background: Poor sleep, common during pregnancy, is associated with negative health risks. The study aimed to identify predictors of clinically significant insomnia among pregnant Latinas. Methods: A total of 1289 pregnant Latinas recruited from obstetric clinics completed the Insomnia Severity Index (ISI) and questions about demographics and sleep. Results: Clinically significant insomnia (ISI ‡ 10) was present among 17% of participants. Significant correlates of clinically significant insomnia were higher scores on the Edinburgh Postnatal Depression Scale (EPDS) after removing the sleep item (47% of women with EPDS ‡ 9 and 9% with EPDS < 9), completing measures in English (rather than Spanish: 26% versus 13%), and income but not pregnancy week, age, highest education level, or marital status. The highest percentage of clinically significant insomnia (59%) was experienced by women with EPDS ‡ 9 who completed measures in English. The lowest percentage of clinically significant insomnia (6.2%) was experienced by women with EPDS < 9 who completed measures in Spanish. Conclusions: In this sample of low-income, mostly Spanish-speaking pregnant Latinas, rates of clinically significant insomnia appear to be higher than rates among nonpregnant Latinas. Rates of clinically significant insomnia are particularly high among Latinas with elevated depressive symptom severity, a known risk for insomnia. Acculturation, as indicated by completing measures in English, may be another risk specific to Latinas, possibly owing to loss of some ethnicity-specific protective factors (e.g., social support, strong family ties, and group identity). It will be important to directly test this explanation in future research.

show abstract

Section: Discussionsupporting

confidence: 82%

Factors Associated with Clinically Significant Insomnia Among Pregnant Low-Income Latinas

Manber

Steidtmann

Chambers

et al. 2013

Journal of Women's Health

View full text Add to dashboard Cite

show abstract

“…A strength of this study is that it replicates key findings from recent work focusing on depressive and anxiety symptoms among non-clinical samples (Bei et al, 2010;Skouteris et al, 2009;Swanson et al, 2011;Wu et al, 2014). Instead of excluding women with high symptoms (Wu et al, 2014), we used borderline cut-offs, as mild depressive and anxiety symptoms are more common in the general population.…”

Section: Discussionsupporting

confidence: 73%

“…Indeed, more recent studies found that subjective sleep quality during pregnancy was associated with (Skouteris et al, 2009) or had additive effects on postnatal depression (Bei et al, 2010;Wu et al, 2014). Although a few previous studies found that poor subjective prenatal sleep quality was also correlated with higher levels of postnatal anxiety (Skouteris et al, 2009;Swanson et al, 2011), a recent review found not enough evidence (Lawson et al, 2015).…”

Section: Introductionmentioning

confidence: 98%

Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms

Tham

Tan

Chong

et al. 2016

Journal of Affective Disorders

View full text Add to dashboard Cite

“…41 Several studies of pregnant women report high rates of insomnia symptoms. Swanson et al 42 reported that 45% of pregnant women scored above the threshold value, and Fernandez-Alonso et al 43 identified more than 73% in late pregnancy. Manber and colleagues, 44 however, reported that only 17% of Latina women, across all trimesters, met criteria for insomnia (≥ 10) and that there was no difference across trimesters.…”

Section: S C I E N T I F I C I N V E S T I G At I O N Smentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identifi cation of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation. Methods: The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specifi city, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests. Results: The ISQ identifi ed 12.6% of the sample as meeting a case defi nition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specifi city (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion. Conclusions: Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen. 1 Among the many sleep complaints associated with pregnancy, diffi culty initiating or maintaining sleep or unrefreshing sleep, are the most frequently reported issues .1,2 Collectively these sleep symptoms comprise only one aspect of clinical insomnia. According to diagnostic criteria for insomnia, one must have: (1) a diffi culty initiating or maintaining sleep, and/or unrefreshing sleep despite adequate opportunity for sleep; (2) the duration of the sleep complaint is at least 1 mo; and (3) complaints of significant impairment in social, occupational, or daily functioning. 3,4 Insomnia is associated with activation of the stress system resulting in autonomic hyperarousa l. 5,6 It is also linked to various morbidities including depressi on.7-12 Emerging evidence implicates autonomic hyperarousal as a pathway through which the risk of depression is augmen ted. 13 This association is particularly relevant for pregnant women because there is evidence that depression is associated with an increased risk for preterm birth ( PTB), 14 and prenatal depression negatively impairs maternal-child bonding and neurocognitive develo pment.14-17 Having a simple diagnostic tool to identify clinical insomnia in pregnant women could be a fi rst step in reducing the incidence of depression, autonomic hyperarousal, as well as adverse pregnancy outcomes, such as PT...

show abstract

Relationships Among Depression, Anxiety, and Insomnia Symptoms in Perinatal Women Seeking Mental Health Treatment

Cited by 120 publications

References 24 publications

Factors Associated with Clinically Significant Insomnia Among Pregnant Low-Income Latinas

Factors Associated with Clinically Significant Insomnia Among Pregnant Low-Income Latinas

Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Contact Info

Product

Resources

About