0356 Subjective Sleep Quality in Postpartum Women Enrolled in a Study of CBT for Insomnia

Abstract

Introduction Poor sleep is frequently reported postpartum and is often attributed to factors related to the infant. This study examined how perceived infant-related sleep disturbances and maternal sleep-factors contribute to maternal subjective sleep quality. Methods Participants were postpartum women who enrolled in a randomized control trial for perinatal insomnia. Participants were randomized to receive either cognitive behavioral therapy for insomnia (CBTI) or an active control insomnia therapy. The analysis included 68 participants (age 34±5.6) who completed the Insomnia Severity Index (ISI) and one week of the consensus sleep diaries at 18 weeks postpartum. Sleep diary items assessing wakefulness after sleep onset (WASO) separated the number and duration of awakenings related and unrelated to the infant. An additional diary item assessed the perceived impact of the infant on maternal sleep (5-point Likert-type scale, very-little to very-much). Results Mean rating for sleep quality did not differ between the CBTI (n=36) and control therapy (n=32) groups (p=0.7). A linear regression analysis, with subjective sleep quality as the dependent variable and ISI and sleep diary derived variables as independent variables, revealed the following predictors of maternal subjective sleep quality: perceived impact of the infant on participants' sleep (β=-0.45, p<0.001) and mean sleep onset latency (β=-0.19, p=0.043). In contrast, ISI, total sleep time, number and minute of WASO (both related and unrelated to infant), and treatment assignment were not significant predictors of the subjective sleep quality. Conclusion Maternal perception of how much her infant disturbed her sleep, rather than her reported number and duration of awakenings due to the infant, appears relevant to her perception of the quality of her sleep. Poor subjective sleep quality has been previously associated with myriad negative sequelae, including postpartum mood symptoms. Therefore, our findings point to the psychological impact of the infant on maternal sleep as an important target for sleep-related interventions during the postpartum period. Support (If Any) N/A [ABSTRACT FROM AUTHOR]