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Comparative effectiveness of nonpharmacological interventions on postpartum maternal sleep quality: a systematic
Cai Thi Thuy Nguyen1,2,3, Hsiao-Yean Chiu3, Marianne Lin-Lewry4,5
1Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
Study Objectives:
Poor sleep quality is prevalent among postpartum females and can impair maternal and family health. Nonpharmacological interventions are preferred approaches over pharmaceutical methods for improving postpartum sleep, though their comparative effects remain unclear. This study aimed to systematically compare and rank the effects of various nonpharmacological interventions on maternal sleep quality at different postpartum stages.
Methods:
A systematic review and network meta-analysis was conducted. Electronic databases were systematically searched from their inception to July 2024. Randomized controlled trials of nonpharmacological interventions for postpartum sleep were included. Random-effects network meta-analyses were adopted.
Results:
In total, 19 randomized controlled trials involving 1,826 participants examined 13 nonpharmacological interventions for postpartum sleep quality. Foot reflexology demonstrated the largest effect size (standardized mean difference [SMD] = -3.5), followed by progressive muscle relaxation (SMD = -3.2) and massage (SMD = -2.0), compared to usual care during the first 3 months postpartum. Cognitive behavioral therapy for insomnia (SMD = -1.7) and light-dark therapy (SMD = -1.3) are effective during 4-12 months postpartum.
Conclusions:
Nonpharmacological interventions effectively improve postpartum sleep, with foot reflexology being the most effective in the early postpartum period and cognitive behavioral therapy for insomnia optimal for 4-12 months. Health professionals can incorporate these promising interventions into postpartum sleep care. Future research evaluating the direct comparisons of nonpharmacological interventions for postpartum sleep is warranted.
Citation:
Nguyen CTT, Chiu H-Y, Lin-Lewry M, Bei B, Tsai S-Y, Kuo S-Y. Comparative effectiveness of nonpharmacological interventions on postpartum maternal sleep quality: a systematic review and network meta-analysis. J Clin Sleep Med. 2025;21(11):1957-1967.
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