Cited by 190Maternal Mental Health During Pregnancy and PostpartumSleep and related disordersPregnancy-related medical research

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Sleep quality and depression during pregnancy: a prospective study

SKOUTERIS, HELEN, GERMANO, CARMELA, WERTHEIM, ELEANOR H., PAXTON, SUSAN J., MILGROM, JEANNETTE·2008·Journal of Sleep Research

DOI 10.1111/j.1365-2869.2008.00655.x

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Abstract

For the first time, the relationship between depressive symptoms and sleep quality was explored prospectively during pregnancy. Participants (n = 273) completed the Pittsburgh Sleep Quality Index and Beck Depression Inventory at three 8-week intervals, starting from 15-23 weeks gestation. In addition to sleep quality and depression remaining relatively stable during pregnancy, findings revealed that sleep quality earlier in pregnancy predicted higher levels of depressive symptoms at later stage in pregnancy (after controlling for prior depression levels). In contrast, there was no evidence to suggest that depressive symptoms earlier in pregnancy impacted on sleep quality later on. Given that depressive symptomatology can lead to major depression and given the prevalence of pre- and postnatal depression, our findings suggest that screening for sleep problems during pregnancy may be of clinical significance.

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Untitled work
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BackgroundResult
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BackgroundMethodInfluential
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Background
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BackgroundResult
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Background
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BackgroundMethod
Psychosocial Characteristics and Gestational Weight Change among Overweight, African American Pregnant Women
Allison, K. C., Wrotniak, B. H., Paré, E., & Sarwer, D. B. (2012) · Obstetrics and Gynecology International · doi:10.1155/2012/878607 · Cited by 42
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Background
Poor Postpartum Sleep Quality Predicts Subsequent Postpartum Depressive Symptoms in a High-Risk Sample
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“Poor sleep has been suggested to be the cause rather than the consequence of elevated depressive symptoms in pregnant women (29).”
Background
Longitudinal associations between sleep and anxiety during pregnancy, and the moderating effect of resilience, using parallel process latent growth curve models
van der Zwan, J. E., de Vente, W., Tolvanen, M., Karlsson, H., Buil, J. M., Koot, H. M., Paavonen, E. J., Polo‐Kantola, P., Huizink, A. C., & Karlsson, L. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.08.023 · Cited by 39
“The findings of decreasing sleep quality and shortening of sleep duration during pregnancy are consistent with previous literature [1,10,14].”
Result
Insomnia symptoms increase during pregnancy, but no increase in sleepiness - Associations with symptoms of depression and anxiety
Aukia, L., Paavonen, E. J., Jänkälä, T., Tolvanen, M., Korja, R., Karlsson, L., Karlsson, H., & Polo‐Kantola, P. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.03.031 · Cited by 37
Maternal pre- and postnatal mental health trajectories and child mental health and development
Vänskä, M., Punamäki, R., Tolvanen, A. J., Lindblom, J., Flykt, M. S., Unkila‐Kallio, L., Tiitinen, A. E., Repokari, L., Sinkkonen, J., & Tulppala, M. (2011) · International Journal of Behavioral Development · doi:10.1177/0165025411417505 · Cited by 36
Sleep quality and associated factors among pregnant women attending antenatal care unit at Gondar, Ethiopia: a cross-sectional study
Takelle, G. M., Muluneh, N. Y., & Biresaw, M. S. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-056564 · Cited by 35
Cognitive Behavioral Therapy for Insomnia and Women's Health
Nowakowski, S., & Meers, J. M. (2019) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2019.01.002 · Cited by 38
Objective sleep efficiency but not subjective sleep quality is associated with longitudinal risk of depression in pregnant women: A prospective observational cohort study
Tsai, S., Lee, P., Gordon, C. J., Cayanan, E. A., & Lee, C. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.103966 · Cited by 35
Postpartum depressive symptoms and its association to daytime sleepiness and restless legs during pregnancy
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“There is evidence that disturbed sleep precedes depressive symptoms in the general population [5] and that poor sleep quality in early pregnancy might contribute to antepartum depressive symptoms during pregnancy [17].”
Background
The Experience of and Coping with Lumbopelvic Pain among Pregnant Women in Taiwan
Chang, H., Yang, Y., Jensen, M. P., Lee, C., & Lai, Y. (2011) · Pain Medicine · doi:10.1111/j.1526-4637.2011.01151.x · Cited by 34
Neuroendocrine Effects of Lactation and Hormone-Gene-Environment Interactions
Gust, K. M., Caccese, C., Larosa, A., & Nguyen, T. (2020) · Molecular Neurobiology · doi:10.1007/s12035-019-01855-8 · Cited by 40
Habitual snoring and depressive symptoms during pregnancy
O'Brien, L. M., Owusu, J. T., & Swanson, L. M. (2013) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-13-113 · Cited by 32
“In recent years several studies have shown a relationship between poor sleep and depressive symptoms in pregnant and postpartum women [9-11,14,30-32].”
Background
Sleep in Women: A Review
Bei, B., Coo, S., Baker, F. C., & Trinder, J. C. (2015) · Australian Psychologist · doi:10.1111/ap.12095 · Cited by 40
Protocol for a randomized controlled trial of a specialized health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women: the HIPP study
Skouteris, H., McCabe, M. P., Milgrom, J., Kent, B., Bruce, L. J., Mihalopoulos, C., Herring, S. J., Barnett, M., Patterson, D., Teale, G. R., et al. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-78 · Cited by 31
“Our estimate of a drop-out rate is conservative and based on our previous large longitudinal studies with pregnant women and multiple time points [21,23,64].”
Selective serotonin reuptake inhibitors for depression in pregnancy
Susser, L. C., Sansone, S. A., & Hermann, A. D. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2016.07.011 · Cited by 35
Sleep quality and its relationship with quality of life in Iranian pregnant women
Effati-Daryani, F., Mirghafourvand‬‬‬‬‬‬‬‬‬‬‬‬‬‬, M., Mohammad‐Alizadeh‐Charandabi, S., Shiri‐Sarand, F., & Zarei, S. (2017) · International Journal of Nursing Practice · doi:10.1111/ijn.12518 · Cited by 31
Associations between Maternal Sleep Quality Throughout Pregnancy and Newborn Birth Weight
Liu, H., Hong, L., Li, C., Chen, L., Zhang, C., Liu, Z., Wu, Y., & Huang, H. (2019) · Behavioral Sleep Medicine · doi:10.1080/15402002.2019.1702551 · Cited by 31
A scoping review of non-pharmacological perinatal interventions impacting maternal sleep and maternal mental health
Ladyman, C., Sweeney, B., Sharkey, K. M., Bei, B., Wright, T., Mooney, H., Huthwaite, M., Cunningham, C. W., Firestone, R. T., & Signal, T. L. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04844-3 · Cited by 39
“Women with greater levels of depressive symptoms report more sleep disruption [5], and women with poor sleep are more likely to experience depressive symptoms both antenatally [6, 7], and postnatally [8, 9].”
Background
Short sleep duration, complaints of vital exhaustion and perceived stress are prevalent among pregnant women with mood and anxiety disorders
Qiu, C., Gelaye, B., Fida, N., & Williams, M. A. (2012) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-12-104 · Cited by 31
“Sleep disturbance is both a defining feature of depression diagnosis [7], and is a prodromal symptom of both new and recurrent depressive episodes [18,19].”
Background
The influence of psychological factors on post‐partum weight retention at 9 months
Phillips, J., King, R. M., & Skouteris, H. (2013) · British Journal of Health Psychology · doi:10.1111/bjhp.12074 · Cited by 32
Shift work and depressive symptoms: the mediating effect of vitamin D and sleep quality
Park, H., Suh, B.-S., & Lee, S. (2019) · Chronobiology International · doi:10.1080/07420528.2019.1585367 · Cited by 27
“The association between poor sleep quality and depressive symptoms has been found in many other groups as well (Skouteris et al. 2008, 2009).”
Background
Perinatal Sleep Problems
Wilkerson, A. K., & Uhde, T. W. (2018) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2018.04.003 · Cited by 27
Goodness of fit between prenatal maternal sleep and infant sleep: Associations with maternal depression and attachment security
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Changes in Sleep Patterns during Pregnancy and Predictive Factors: A Longitudinal Study in Saudi Women
Al-Musharaf, S. (2022) · Nutrients · doi:10.3390/nu14132633 · Cited by 25
“Several studies also support our finding that sleep patterns worsen as pregnancy progresses, as reflected by the increasing total PSQI scores over time [9,18,48,49].”
Result
Association of Body Weight and Female Sexual Dysfunction: A Case Control Study
Mozafari, M., Khajavikhan, J., Jaafarpour, M., Khani, A., Moghadam, Z. B., & Najafi, F. (2015) · Iranian Red Crescent Medical Journal · doi:10.5812/ircmj.11420 · Cited by 25
“Sleep quality early pregnancy may contribute to the higher development levels of depressive symptoms in later pregnancy, Given that depressive symptoms can lead to clinical depression (35).”
Background
A prospective study on the course of sleep disturbances in first‐time fathers during the transition to parenthood
Costa, D. D., Lai, J., & Zelkowitz, P. (2021) · Infant Mental Health Journal · doi:10.1002/imhj.21911 · Cited by 25
Association between depressive symptoms and poor sleep quality among pregnant women in Northern Rural Bangladesh: a community-based cross-sectional study
Shaun, M. M. A., Nizum, M. W. R., Shuvo, M. A., Fayeza, F., Faruk, M. O., Alam, M. F., Ahmed, M. S., Zaman, S., Mali, S. K., & Hawlader, M. D. H. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03839-w · Cited by 24
Poor sleep Quality and Obstructive Sleep Apnea are Associated with Maternal Mood, and Anxiety Disorders in Pregnancy
Rubio, E., Levey, E. J., Rondón, M. B., Friedman, L. E., Sánchez, S. E., Williams, M. A., & Gelaye, B. (2022) · Maternal and Child Health Journal · doi:10.1007/s10995-022-03449-8 · Cited by 26
“Our findings are consistent with previous studies examining the association of sleep quality with depression during pregnancy (Chang et al., 2015; Skouteris et al., 2008; Yu et al., 2017).”
BackgroundResult
Determinants of sleep quality among pregnant women in China: A cross-sectional survey
Yang, Y., Mao, J., Ye, Z., Li, J., Zhao, H., & Liu, Y. (2017) · Nursing and Palliative Care · doi:10.15761/npc.1000152 · Cited by 23
Association of Depression and Unhealthy Lifestyle Behaviors in Chinese Patients With Acute Coronary Syndromes
Zhu, Y., Yu, X., Wu, Y., Shi, C., Zhang, A., Jiang, R., Li, S., Guo, G., Gao, R., & Blumenthal, J. A. (2019) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000384 · Cited by 24
Maternal insomnia during the COVID-19 pandemic: associations with depression and anxiety
Wang, J., Zhou, Y., Qian, W., Zhou, Y., Han, R., & Liu, Z. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02072-2 · Cited by 23
“As a form of emotional distress, depression is closely related to insomnia [64] , which is especially evident in pregnant women [65], and the positive predictive effect of depression on insomnia may be due to their common genetic components.”
Background
Sleep Quality and Performance in Professional Athletes Fasting during the Month of Ramadan
Lipert, A., Kozłowski, R., Rasmus, P., Marczak, M., Timler, M., Timler, D., Kaniecka, E., Nasser, A., Ghaddar, M., & Ghaddar, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136890 · Cited by 22
“…has been validated in numerous populations and languages [23,24] as well as many medical populations such as patients with insomnia, patients with traumatic brain injury, patients with cancer, patients receiving bone marrow and renal transplants, nursing home residents and pregnant women [25,26].”
Prenatal sleep quality and mental health symptoms across the perinatal period: A longitudinal study of high-risk women
Paulson, J. L., & Miller‐Graff, L. E. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.11.011 · Cited by 22
Effects of Acupressure and Acupuncture-Like Transcutaneous Electrical Nerve Stimulation on Sleep Quality Among Pregnant Women
Sokunbi, G. O., Takai, I. U., Nwosu, I. B., & Balarabe, R. (2020) · Journal of Acupuncture and Meridian Studies · doi:10.1016/j.jams.2020.10.003 · Cited by 21
“Studies have also elucidated that pregnant women with depression have various types of insomnia symptoms and reduced sleep quality [12,13].”
Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women
D'Anna‐Hernandez, K., Garcia, E. R., Coussons‐Read, M. E., Laudenslager, M. L., & Ross, R. G. (2016) · Maternal and Child Health Journal · doi:10.1007/s10995-015-1840-9 · Cited by 19
“Sleep disturbances contribute to depression during pregnancy [47, 77, 87, 88], however, the role of acculturation in maternal depression is less clear [2, 4, 34].”
Background
Psychometric and structural validity of the Pittsburgh sleep quality index among Filipino domestic workers
Xiong, P., Spira, A. P., & Hall, B. J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17145219 · Cited by 19
Sleep quality in women with nausea and vomiting of pregnancy: a cross-sectional study
Laitinen, L. M., Nurmi, M., Rautava, P. T., Koivisto, M. A., & Polo‐Kantola, P. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03639-2 · Cited by 19
Examining Experiences of Poor Sleep During Pregnancy: A Qualitative Study to Inform the Development of a Prenatal Sleep Intervention
Felder, J. N., Mirchandaney, R., Harrison, J. M., Manber, R., Cuneo, J., Krystal, A. D., Epel, E. S., & Hecht, F. M. (2022) · Global Advances in Health and Medicine · doi:10.1177/2164957x221087655 · Cited by 19
Sleep during the third trimester of pregnancy: the role of depression and anxiety
Ruiz‐Robledillo, N., Canário, C., Dias, C. C., Moya‐Albiol, L., & Figueiredo, B. (2015) · Psychology Health & Medicine · doi:10.1080/13548506.2015.1017508 · Cited by 19
“We expect to find high sleep disturbances in depressed pregnant compared to non-depressed (Field et al., 2007; Kamysheva et al., 2010; Okun et al., 2011; Qiu et al., 2012; Skouteris et al., 2008), after controlling for anxiety.”
Nuwa
Gao, Y., Li, X., Lin, Y., Liu, X., & Pang, L. (2014) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/2559206.2580928 · Cited by 19
“We believe that pregnancy is a special couple experience for most people, which involves the cooperation of both expectant parents.”
Exploring the Association between Maternal Mood and Self‐Reports of Sleep during the Perinatal Period
Coo, S., Milgrom, J., Kuppens, P., Cox, P., & Trinder, J. C. (2014) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/1552-6909.12464 · Cited by 19
“The PSQI has been used extensively with perinatal women (Dørheim, Bondevik, EberhardGran, & Bjorvatn, 2009; Skouteris et al., 2008).”
Method
The influence of psychological distress during pregnancy on early postpartum weight retention
Phillips, J., King, R. M., & Skouteris, H. (2013) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2013.845873 · Cited by 18
Mild Depressive Symptoms During the Third Trimester of Pregnancy Are Associated with Disruptions in Daily Rhythms but Not Subjective Sleep Quality
Simpson, W. S., Frey, B. N., & Steiner, M. S. (2015) · Journal of Women s Health · doi:10.1089/jwh.2015.5404 · Cited by 18
A conceptual model of psychological predictors of postpartum weight retention
Phillips, J., King, R. M., & Skouteris, H. (2012) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2012.717265 · Cited by 20
“For example, disturbed sleep quality during the later stages of pregnancy predicts symptoms of depression in the first few weeks postpartum (Skouteris, Germano, Wertheim, Paxton, & Milgrom, 2008 ) and poor sleep quality is also associated with postpartum psychological distress (Herring et al, 2008 ; Siega-Riz et al, 2…”
Background
Qualidade do sono em gestantes com sobrepeso
Ribeiro, M. C., Nakamura, M. U., Torloni, M. R., Scanavino, M. D. T., Forte, B., Mancini, P. E., & Mattar, R. (2015) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1590/so100-720320150005415 · Cited by 17
“≥2 14 (20,9) 14 (27,4) 0,7** 12 (23,5) 16 (29,6) 0,7**”

Authors: SKOUTERIS, H., GERMANO, C., WERTHEIM, E. H., PAXTON, S. J., & MILGROM, J.
Affiliations: Deakin University (AU)
La Trobe University (AU)
The University of Melbourne (AU)
Corresponding author: WERTHEIM, ELEANOR H.
ORCID: SKOUTERIS, HELEN
WERTHEIM, ELEANOR H.
PAXTON, SUSAN J.
MILGROM, JEANNETTE
Venue: Journal of Sleep Research
Publisher: Wiley
Published: 2008-06
Volume: 17
Issue: 2
Pages: 217-220
ISSN: 0962-1105 (ISSN-L)
1365-2869
DOI: 10.1111/j.1365-2869.2008.00655.x
OpenAlex: W2143429143
Cited by: 190
References: 30
Citations by year: 2026: 1 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 17 · 2021: 18 · 2020: 16 · 2019: 12 · 2018: 8 · 2017: 9 · 2016: 20 · 2015: 17 · 2014: 10 · 2013: 15 · 2012: 10
FWCI: 5.96
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 27 d)
Locations: Journal of Sleep Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: sleep quality, depression, pregnancy, depressive symptoms, sleep disorders, longitudinal change, sleep screening
MeSH terms: Adolescent, Adult, Cross-Sectional Studies, Depressive Disorder, Female, Gestational Age, Health Surveys, Humans, Disorders of Excessive Somnolence, Infant, Newborn, Sleep Initiation and Maintenance Disorders, Mass Screening, Personality Inventory, Pregnancy, Pregnancy Complications, Prospective Studies, Risk Factors, Statistics as Topic, Causality

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Sleep quality and depression during pregnancy: a prospective study

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