Depression in New Mothers Affects Sleep Quality

Sleep Problems may be Result of Undiagnosed Postpartum Depression

Sep 24, 2009

While most new mothers experience disrupted sleep and exhaustion, research suggests postpartum depression might be the underlying cause in some women.

The baby might not be the only thing affecting mom's sleep. While most new mothers experience disturbed sleep and fatigue, a 2009 study from Norway found that in some women, poor sleep quality is aggravated by undiagnosed postpartum or maternal depression.

Doctors willing to scratch below the surface with new mothers who report feeling excessively tired, might uncover something more serious. Individual screening programs are now being developed to assist health care providers to identify women at risk

Depression in New Mothers Often Hidden Underneath Fatigue Complaints

Researchers in Norway found that tired new mothers aren't necessarily depressed but depressed new mothers often report feeling tired. Not surprising since fatigue is a common symptom in people with depression.

The study found that two months after delivery, poor sleep was associated with depression in women. Other depression risk factors were excluded such as whether a woman had a poor partner relationship, previous depression, depression during pregnancy and stressful life events.

According to the research study reported in ScienceDaily, nearly 60 percent of postpartum women surveyed experienced poor sleep quality, and 16.5% had depressive symptoms. What's significant, suggests lead study author Dr. Karen Dørheim, is while not all postpartum mothers tell their doctor they're depressed, many will complain of being tired, a complaint universally associated with having a newborn. Yet the symptoms might be caused by underlying depression.

Risk Factors Associated with Postpartum Depression and Poor Maternal Sleep

Risk factors for postpartum depression include a prior history of depression, depression during pregnancy, having blood relatives with depression, poor social support, adverse/stressful life events, marital instability and ambivalence towards the pregnancy.

Researchers found that in addition to depression, poor postpartum sleep is also associated with a history of sleep problems, being a first time mother, not exclusively breastfeeding or having a younger or male infant. Mothers slept better however, when the baby slept in another room.

Women also react individually to getting less sleep during the postpartum period. Women with a history of depression may be more sensitive to the hormonal, immunological, psychological and social changes associated with childbirth.

Postpartum Depression Screening Offers Improved Diagnostics

While postpartum depression is often under diagnosed, new screening methods are being developed to assist health care providers. "It is important to ask a new mother suffering from tiredness about how poor sleep affects her daytime functioning and whether there are other factors in her life that may contribute to her lack of energy," says Dr. Dørheim.

University of Toronto nursing professor Cindy-Lee Dennis found after reviewing 15 studies on postpartum depression prevention strategies that pre-natal prevention classes were largely ineffective. The programs weren't necessarily weak Dennis explained, rather compliance by the women was low. Women were not attending classes.

Dennis suggests that with the right program and cooperation by health care providers and their patients, postpartum depression might be preventable. Group intervention, the review showed, is not as effective as individual assessment and intensive support. Immediacy, accessibility and structure are also key. "You must have a structured assessment within the first four weeks after birth with referrals to appropriate services that are accessible," says Dennis.

While poor sleep and fatigue is believed to be the norm for all new mothers, postpartum depression may be an underlying aggravating factor for some women. As doctors become increasingly sensitive to new mothers' physical and emotional symptoms and postpartum depression screening programs improve, more women at risk will be diagnosed and treated.

Dørheim SK, et al, "Sleep and depression in postpartum women: a population-based study," Sleep, 2009 Jul 1;32(7):847-55.

University of Toronto, (July 18, 2005), "Postpartum Treatment Key For Depression; Prenatal Efforts Ineffective," ScienceDaily.

The copyright of the article Depression in New Mothers Affects Sleep Quality in Women’s Health is owned by Laura Owens. Permission to republish Depression in New Mothers Affects Sleep Quality in print or online must be granted by the author in writing.