Fathers' sleep in the first 24 months postpartum: A systematic review and meta-analysis of global data

Maternal sleep is significantly disrupted in the postpartum period, but changes in paternal sleep are less established. Here, we systematically review and meta-analyze available data on paternal sleep in the first 24months post birth, including self-report and objectively measured sleep outcomes. Scopus, PsycINFO, and PubMed were searched for original research articles published until end August 2024. We included studies reporting on quantitative summaries of sleep outcomes and data were pooled using random-effects models primarily. We included 47 studies from 17 countries (N=9684) with most data coming from fathers in North America (K=26), and reporting on a diverse range of sleep outcomes. Most data were available for sleep duration (398.29 minutes; 95% CIs 381.43-415.88), night awakenings (1.14; 95% CIs 1.12-1.16), and wake after sleep onset (36.57 minutes; 95% CIs 20.83-64.20). There was high heterogeneity across these three measures (I² values >95%). While there were a small number of studies using the Pittsburgh Sleep Quality Index, our pooled estimate suggested poor sleep in fathers (5.93, 95% CIs 4.75-7.41, I²=91%). Overall, we found some evidence for sleep in few fathers being below the recommended levels, but the extent of any paternal deficit depended on the sleep measure. The US-centric dataset limits our understanding of fathers' sleep experiences postnatally, particularly considering the large relative differences between paternity leave access in the United States vs. other countries.