CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0044-1782174
Original Article

Factors Associated with Poor Sleep Quality in Postpartum Women: A Crossectional Study

Ana Júlia Pereira Motta
,
,
Graciele Cristina Silva Leão
,
Dayane Eusenia Rosa
,
Vilmar De Assis Gonçalves Junior
,
Revora Silverio Mendonça
Funding Source The author(s) received no financial support for the research.

Abstract

Objective This study aimed to analyze the factors associated with poor sleep quality in women in the postpartum period who were assisted in a municipality in central Brazil.

Material and Methods This is a cross-sectional study (n = 400) conducted virtually from 2020 to 2021. Sociodemographic and clinical characteristics, self-perceived sleep, and the Pittsburgh Sleep Quality Index (PSQI) were assessed.

Results It was identified that 82% of postpartum women were between 18 and 35-years-old and had an average monthly household income of R$2,339.27 ± 1,812.95. It was also found that 33.50% (95% CI: 28.7–38.0) had sleep disorders (PSQI >10); 70.25% (95%CI 65.8–74.8) had poor sleep quality (PSQI >5); 57.4% (95% CI: 52.0–63.1) had inadequate sleep on weekdays/workdays; and 64.1% (95% CI 59.3–69.2) had unsuitable sleep on weekends/days off. It was found that the factors associated with sleep disturbance were: age between <18 years and >35 years (p = 0.048); difficulty to think clearly (p = 0.043); frequent sadness (p = 0.046); poor sleep quality; low income (p = 0.030); difficulty to think clearly (p = 0.013); and loss of interest in things (p = 0.030). As for sleep on weekdays, the associated factors were: marital status without a partner (p = 0.008); and being a victim of physical violence (p = 0.003). Finally, for sleep on weekends/off: nonwhite skin-color (p = 0.039); and having postpartum depression (p = 0.029).

Conclusion The findings of the present study call attention to the impacts of changes in women's bodies, behavior, and interpersonal relationships caused by the arrival of a newborn. We also highlight the need for a multidisciplinary and comprehensive medical approach in this period.



Publication History

Received: 26 December 2022

Accepted: 03 October 2023

Article published online:
15 May 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Sevil U, Ertem G. Postpartum Period, ‘Periatology and Care’, 1st edn. Nobel Medicine Publisher; 2016. . p. 409-41
  • 2 Mokhtaryan-Gilani T, Kariman N, Nia HS. et al. Avaliação dos Preditores da Qualidade de Vida no Puerpério: Um Estudo Transversal. Iran J Public Health 2022; 51 (06) 1389-1399
  • 3 Yildiz H, Kucuksahin N. Postpartum problems and care needs of mothers living in a rural area. Turk Aile Hekim Derg 2013; 15: 159-166
  • 4 Aksu S, Varol FG, Hotun Sahin N. Long-term postpartum health problems in Turkish women: prevalence and associations with self-rated health. Contemp Nurse 2017; 53 (02) 167-181
  • 5 Okun ML. Disturbed sleep and postpartum depression. Curr Psychiatry Rep 2016; 18 (07) 66
  • 6 Kennedy HP, Gardiner A, Gay C, Lee KA. Negotiating sleep: a qualitative study of new mothers. J Perinat Neonatal Nurs 2007; 21 (02) 114-122
  • 7 National Sleep Foundation. Sleep Foundation. 2012 . Available from: https://www.sleepfoundation.org/ . Accessed Nov 2, 2022.
  • 8 Coo S, Milgrom J, Trinder J. Mood and objective and subjective measures of sleep during late pregnancy and the postpartum period. Behav Sleep Med 2014; 12 (04) 317-330
  • 9 Fujiwara T, Yamaoka Y, Morisaki N. Self-reported prevalence and risk factors for shaking and smothering among mothers of 4-month-old infants in Japan. J Epidemiol 2016; 26 (01) 4-13
  • 10 Gress-Smith JL, Luecken LJ, Lemery-Chalfant K, Howe R. Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Matern Child Health J 2012; 16 (04) 887-893
  • 11 Insana SP, Williams KB, Montgomery-Downs HE. Sleep disturbance and neurobehavioral performance among postpartum women. Sleep 2013; 36 (01) 73-81
  • 12 Piteo AM, Roberts RM, Nettelbeck T. et al. Postnatal depression mediates the relationship between infant and maternal sleep disruption and family dysfunction. Early Hum Dev 2013; 89 (02) 69-74
  • 13 Emamian F, Khazaie H, Okun ML. et al. Link between insomnia and perinatal depressive symptoms: A meta-analysis. J Sleep Res 2019; 28 (06) e12858
  • 14 Lee KA, Gay CL. Can modifications to the bedroom environment improve the sleep of new parents? Two randomized controlled trials. Res Nurs Health 2011; 34 (01) 7-19
  • 15 Varcho MS, Hill PD, Anderson M. Evaluation of the Tiredness Management Guide: a pilot study. Appl Nurs Res 2012; 25 (02) 123-128
  • 16 Stremler R, Hodnett E, Kenton L. et al. Effect of behavioural-educational intervention on sleep for primiparous women and their infants in early postpartum: multisite randomised controlled trial. BMJ 2013; 346: f1164
  • 17 Giallo R, Cooklin A, Dunning M, Seymour M. The efficacy of an intervention for the management of postpartum fatigue. J Obstet Gynecol Neonatal Nurs 2014; 43 (05) 598-613
  • 18 Sousa PHSF, Souza RF, Nascimento RT. et al. Fatores de risco associados à depressão pós-parto: Revisão integrativa. Braz J Dev. 2021; 7 (01) 11447-11462
  • 19 da Silva AR, Mangueira SdeO, Perrelli JGA. et al. Avaliação do diagnóstico de enfermagem Padrão de sono prejudicado em puérperas. Rev Cubana Enferm 2020;36(01):
  • 20 Motta AJ, Lucchese R, Souza R. et al. Má qualidade do sono em mulheres no período puerperal. Braz J Dev. 2022; 8 (11) 75233-75245
  • 21 Comitê de Ética em Pesquisa da UFG/Regional Catalão - UFCAT “em transição” aos nove dias do mês de julho de 2020. Segunda Nota Informativa: Protocolos aprovados antes da pandemia e que necessitam de adequações para darem continuidade à pesquisa.
  • 22 Silva V, Ferreira C, Basílio A. et al. Sintomatologia depressiva no termo da gestação, em mulheres de baixo risco. J Bras Psiquiatr 2019; 68: 65-71
  • 23 Buysse DJ, Reynolds III CF, Monk TH. et al. Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 1991; 14 (04) 331-338
  • 24 Bertolazi AN, Fagondes SC, Hoff LS. et al. Validation of the Brazilian Portuguese version of the Pittsburgh sleep quality index. Sleep Med 2011; 12 (01) 70-75
  • 25 Zhong QY, Gelaye B, Sánchez SE, Williams MA. Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women. J Clin Sleep Med 2015; 11 (08) 869-877
  • 26 Qiu C, Gelaye B, Zhong QY. et al. Construct validity and factor structure of the Pittsburgh Sleep Quality Index among pregnant women in a Pacific-Northwest cohort. Sleep Breath 2016; 20 (01) 293-301
  • 27 Okun ML, Mancuso RA, Hobel CJ. et al. Poor sleep quality increases symptoms of depression and anxiety in postpartum women. J Behav Med 2018; 41 (05) 703-710
  • 28 Fonseca DC, Galdino DAA, Guimarães LHC, Alves DAG. Avaliação da qualidade do sono e sonolência excessiva diurna em mulheres idosas com incontinência urinária. Rev Neurociências. 2010; 18 (03) 294-299
  • 29 Harding TW, de Arango MV, Baltazar J. et al. Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychol Med 1980; 10 (02) 231-241
  • 30 Santos KOB, Araújo TM, Pinho PS, Silva ACC. Avaliação de um instrumento de mensuração de morbidade psíquica: estudo de validação do Self-Reporting Questionnaire (SRQ-20). Rev Baiana Saúde Pública. 2010; 34 (03) 544
  • 31 Mari JJ, Williams P. A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. Br J Psychiatry 1986; 148 (01) 23-26
  • 32 Lee H, Kim KE, Kim MY, Park CG. Comparison of factor structures of the Pittsburgh sleep quality index between mid- and late pregnancy among Korean women: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22 (01) 694
  • 33 Creti L, Libman E, Rizzo D. et al. Sleep in the postpartum: Characteristics of first-time, healthy mothers. Sleep Disord 2017; 2017: 8520358
  • 34 Csipo T, Lipecz A, Owens C. et al. Sleep deprivation impairs cognitive performance, alters task-associated cerebral blood flow and decreases cortical neurovascular coupling-related hemodynamic responses. Sci Rep 2021; 11 (01) 20994
  • 35 Maghami M, Shariatpanahi SP, Habibi D. et al. Sleep disorders during pregnancy and postpartum depression: A systematic review and meta-analysis. Int J Dev Neurosci 2021; 81 (06) 469-478
  • 36 Janse van Rensburg M, Smith H. Navigating uncertainty, employment and women's safety during COVID-19: Reflections of sexual assault resistance educators. Gend Work Organ 2021; 28 (Suppl. 01) 122-136
  • 37 Mullins E, Hudak ML, Banerjee J. et al. PAN-COVID investigators and the National Perinatal COVID-19 Registry Study Group. Pregnancy and neonatal outcomes of COVID-19: coreporting of common outcomes from PAN-COVID and AAP-SONPM registries. Ultrasound Obstet Gynecol 2021; 57 (04) 573-581
  • 38 Holand BL, Fonseca SG, Drehmer M, Bosa VL. Adequacy of prenatal care considering nutritional assistance in Southern Brazil: Maternar Cohort Study. Cad Saude Publica 2021; 37 (06) e00130320
  • 39 Ghaedrahmati M, Kazemi A, Kheirabadi G. et al. Postpartum depression risk factors: A narrative review. J Educ Health Promot 2017; 6: 60
  • 40 Johnson DA, Jackson CL, Williams NJ, Alcántara C. Are sleep patterns influenced by race/ethnicity - a marker of relative advantage or disadvantage? Evidence to date. Nat Sci Sleep 2019; 11: 79-95
  • 41 Yue L, Zhao R, Xiao Q. et al. The effect of mental health on sleep quality of front-line medical staff during the COVID-19 outbreak in China: A cross-sectional study. PLoS One 2021; 16 (06) e0253753
  • 42 Frieder A, Fersh M, Hainline R, Deligiannidis KM. Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development. CNS Drugs 2019; 33 (03) 265-282
  • 43 de Moraes Costa G, Zanatta FB, Ziegelmann PK. et al. Pharmacological treatments for adults with post-traumatic stress disorder: A network meta-analysis of comparative efficacy and acceptability. J Psychiatr Res 2020; 130: 412-420