Subjective Perception of Sleep, but not its Objective Quality, is Associated with Immediate Postpartum Mood Disturbances in Healthy Women

Study Objectives: This study investigated whether there was a relationship between disrupted sleep and postpartum mood disturbances in women during the week after delivery. Design: Sleep and mood were measured during the third trimester (Time-1) and one week postpartum (Time-2) in a 2-stage longitudinal design. Setting: Participants were recruited from an antenatal clinic in a regional Melbourne hospital. Participants: Forty-four healthy women at low risk for postpartum depression. Interventions: N/A Measurements and Results: Objective sleep was measured by actigraphy and subjective sleep by the Pittsburgh Sleep Quality Index; mood was assessed by the Depression Anxiety Stress Scale, the Hospital Anxiety Depression Scale, and the Positive and Negative Affect Schedule. Sleep and mood questionnaires were administered at Time-1 and Time-2. Wrist actigraphy was collected for one week at both times. After delivery, both objective and subjective nighttime sleep significantly worsened with decreased total sleep time and sleep efficiency, while daytime napping behavior significantly increased. On average, mood improved across all scales after delivery, although 45.95% of the sample experienced deterioration of mood. Regression analyses showed little relationship between Time-1 and Time-2 objective nighttime sleep, and postpartum mood. Variables that related to both Time-1 and Time-2 subjective perception of sleep, including subjective nighttime sleep, sleep-related daytime dysfunction, and daytime napping behavior, were significant predictors of postpartum mood. Conclusions: The perception of poor sleep, and the conscious awareness of its impact during wake-time, might share a stronger relationship with the occurrence of immediate postpartum mood disturbances than actual sleep quality and quantity.