Concurrent and prospective associations between sleep duration and timing and postpartum anxiety symptoms

Postpartum anxiety is understudied and underdiagnosed. Given associations between postpartum anxiety and adverse maternal and infant outcomes, it is crucial to identify patterns and predictors of postpartum anxiety. We examined the associations between sleep duration and timing and postpartum anxiety over 6 months following delivery.

A convenience sample of pregnant women with a history of depression (n = 162; 30-39 weeks) completed self-report measures of sleep, anxiety, and depression in the third trimester and once/month for 6 months following delivery. Concurrent and prospective associations between sleep duration, sleep timing, and postpartum anxiety symptoms were tested via 2-level multilevel models. Depression symptoms and insomnia status were included as covariates.

Clinically significant anxiety symptoms were more common than clinically significant depression symptoms at 3 out of 6 postpartum months (p's < .05). Anxiety symptoms increased over time (p < .001). Shorter month-level sleep duration was associated with higher concurrent anxiety symptoms, particularly in early postpartum months. Sleep timing was not significantly associated with concurrent anxiety symptoms (p > .05). Neither prior month sleep duration nor timing significantly predicted subsequent month anxiety symptoms (p's > .05).

Acute reduction in sleep duration may signal the presence of elevated postpartum anxiety, particularly in the early postpartum months, but may not provide predictive utility for prospective increases in anxiety from month to month. Treatments for postpartum anxiety may benefit from targeting sleep duration. Future research should replicate these findings with objective sleep measures.