Poor sleep in pregnant mothers linked to preterm deliveries

A new study in the November issue of the journal SLEEP linked poor sleep in early and late pregnancy with an increased risk of preterm birth.

Researchers found that women who reported sleep disruptions during the first and third trimesters faced significant risks of delivering prematurely. Even after income levels and medical risks were factored in, the connection still remained. There was no association between quality of sleep in the second trimester and preterm births. Sleep appears to improve in the second trimester but there is no clear reason why.

The study’s authors suggested that inflammation may be the culprit. Growing evidence points to inflammation having a role in triggering the childbirth process early. Sleep disturbances are associated with exaggerated inflammatory responses. The authors also said a combination of sleep disruption and stress could lead to premature delivery.

The good news is that sleep disorders during pregnancy are easily diagnosed. An assessment of a woman’s sleep quality may help identify risk earlier, giving doctors time to step in. If sleep disruptions are occurring, they could be reduced through behavioral modification.

Rock-a-bye Baby: Bedtime Advice for Moms

Moms have a new source of help for putting baby to sleep – the Internet. A yearlong review of the online Customized Sleep Profile shows that the advice given out there worked. Babies and toddlers – and their mothers – were able to sleep better as a result.

The Customized Sleep Profile has a database of sleep information stored in its memory. The information is separated into categories based on a child’s age. When a mom accesses the online program, she fills out a series of questions about her child and her child’s sleep habits. The program analyzes mom’s answers and finds comparable examples in its database.

Suggestions for improving the child’s sleep are based on these examples. The suggestions include things like following a regular bedtime routine, stopping night feedings, and answering fewer cries in the night.

The Customized Sleep Profile is available for free from Johnson & Johnson at http://www.johnsonsbaby.com/sleep .

To test the effectiveness of the Customized Sleep Profile, researchers sent surveys to 264 mothers who were using the online program. After three weeks, 90 percent of the moms said the Customized Sleep Profile was helpful and that they planned to continue using it. Their children were sleeping longer and waking up fewer times during the night, the moms said.

The moms also reported less tension, depression, fatigue and confusion because their babies were sleeping better.

A year later, researchers followed up with 171 of the moms still using the program. Their study was published in the Oct. 15 edition of the Journal of Clinical Sleep Medicine. The results show that the Customized Sleep Profile continued to be a valuable resource.

Read more about this study, or additional blog posts about infants and toddlers. The AASM has more about children’s sleep needs on the Your Sleep website.


Photo By: David Clow

New Mothers Sleep Plenty, Wake Often

No one ever says they expect to catch up on their sleep after having a kid. Somehow, mothers actually get plenty of rest – a full seven hours, according to new findings. Only those hours are sabotaged by waking to care for a sleepless infant for a total of two hours per night.

New mothers’ total sleep time surprised researchers at the University of West Virginia. The results of the study were published in the August issue of the American Journal of Obstetrics & Gynecology.

Participants wore sleep-monitoring devices on their wrists throughout much of the postpartum period. A group of 50 mothers were monitored in weeks 2-13. Another 24 new moms wore wrist actigraphs between the 9th and 16th weeks.

The total sleep time did not change through the later weeks, but the interruptions became less frequent.

Most mothers reported feeling fatigued during the daytime, despite getting more than the recommended amount of total sleep. Repeat overnight disruptions may prevent them completing full sleep cycles.

Few mothers chose to nap to fight off daytime fatigue. Naps that last less than 90 minutes won’t fully make up for lost REM sleep but may help mothers feel better.

In an interview with Reuters Health, head researcher Dr. Hawley E. Montgomery-Downs recommended moms can make up for lost sleep by napping when their baby naps. She also suggested couples who breastfeed can split the overnight duties by having milk ready in bottles.

Parents may also want to take a close look at their parental style. Last week the Sleep Education Blog reported infants wake less often when their parents are warm and emotionally available.

Always make sleep a priority. After all, couples who sleep well while caring for an infant are likely to last.

Pregnancy, Sleep & Postpartum Mood

A new study examined the relationship between disrupted sleep and postpartum mood in mothers. The results were published today in the journal Sleep.

The study from Australia involved 44 healthy women. They all had a low risk for postpartum depression. Their ages ranged from 18 to 41 years. Sleep was measured by actigraphy for seven days during the third trimester and seven days after giving birth.

Results show that sleep deteriorated after delivery. Total sleep time at night fell from 428 minutes in the third trimester to 373 minutes after delivery. Daily nap time increased from 32 minutes to 101 minutes.

Forty-six percent of women had some deterioration of mood after delivery. But the link between objective sleep measures and mood was weak. Variables related to the subjective perception of sleep were stronger predictors of postpartum mood.

“Subjective perception of sleep shared a much stronger relationship with mood,” said lead author Bei Bei. “Women who are concerned about their sleep and/or mood should speak to health care professionals about cognitive-behavioral therapy.”

Bei said that pregnancy is a joyous and exciting time. But it also exposes women to many stressors, including disturbed sleep.

The authors reported that new moms often have a mild mood disturbance a few days after delivery. This is called the “baby blues.”

It tends to involve mood swings and tearfulness. Other symptoms such as irritability, anxiety and headaches may occur. Postpartum blues may last about a week.

Some moms may experience postpartum depression. This involves more severe mood changes that can impair daily functioning. The Office on Women’s Health reports that about 13 percent of pregnant women and new mothers have depression.

Last year a study found a hormonal link between restless legs syndrome and pregnancy.

Read more about sleep and pregnancy on SleepEducation.com. Get sleep tips for new parents from the AASM.

How Moms Influence Teen Sleep

A new study looked for similarities in the sleep patterns of teens and their parents.

The Swiss study involved 293 teens with an average age of almost 18 years; 73 percent were female.

They completed a seven-day sleep log; they also completed questionnaires about their psychological functioning. The teens rated their parents’ sleep and parenting styles.

Results show a correlation between the sleep patterns of the teens and their parents. The study also found that how mothers sleep may have an indirect effect on the sleep of their teens.

Mothers’ poor sleep had a direct impact on their parenting style. This affected the psychological functioning of teens. Parenting style and teens’ mental functioning combined to influence how teens sleep.

The authors concluded that teen sleep problems may mirror an unfavorable parenting style and sleep complaints among mothers. Understanding this relationship could improve family counseling and treatment of teen sleep complaints.

In August the Sleep Education Blog reported that a teen’s sleep pattern may be a marker of his or her risk for developing depression. Another recent study found that technology use may be taking a toll on the sleep of teens.

Get parent tips for teen bed times on SleepEducation.com.

Image by Michael Porter

Sleep, Infants & Breastfeeding

A new study suggests that nighttime breast milk may help babies fall asleep.

Researchers in Spain analyzed the content of breast milk samples. They found a “circadian rhythm” for some nucleotides in the milk. The levels of some nucleotides rose at night; others rose during the day.

"This made us realize that milk induces sleep in babies," lead author Cristina Sánchez told The Telegraph.

She said the finding is important for mothers who pump and store milk for later. Milk pumped during the day shouldn’t be given to a baby at night.

"It is a mistake for the mother to express the milk at a certain time and then store it and feed it to the baby at a different time," she said.

Another study suggests that a mother’s laughter may be good medicine for a sleepless baby. It found that mothers who watched a funny movie had increased levels of melatonin in their breast milk. Melatonin is a hormone that helps regulate your sleep-wake cycle.

Other studies show that breastfeeding may provide additional sleep benefits.

One study involved 196 habitually snoring children. Results show that the severity of sleep-disordered breathing was much lower in children who had been fed breast milk for at least two months.

In 2006 a study suggested that breastfeeding may protect against bedwetting; infants who were breastfed for longer than three months were less likely to suffer from bedwetting during childhood.

Another study found that breastfeeding also may help parents sleep. Parents of breastfeeding infants slept about 40 to 45 minutes longer than parents of infants who were given formula. They also reported less sleep disturbance.

The U.S. Surgeon General recommends that babies be fed only breast milk for the first six months of life.

Read more about sleep and infants. Learn how to help your baby fall asleep with a simple bedtime routine.

Child Sleep Problems May Begin in the Womb

A study in the Aug. 1 issue of the journal Sleep examined prenatal factors that are related to sleep problems in children.

The study involved 289 children born in Finland in 1998; each child was born at term from 37 to 42 weeks of gestation. Sleep was measured by actigraphy for one week when the children were 8 years of age. Parents reported sleep problems and sleep disorder symptoms.

Results link prenatal alcohol exposure to an increased risk of sleep problems in childhood.

Alcohol "exposure" was defined as a mother drinking more than one alcoholic beverage per week during pregnancy.

Children exposed to alcohol before birth were 2.5 times more likely to have a “short” sleep duration of 7.7 hours or less per night. The AASM reports that at 8 years of age children need about nine to 10 hours of nightly sleep.

Children also were 3.6 times more likely to have a low “sleep efficiency” of 77.2 percent or less if they were exposed to alcohol in the womb; sleep efficiency indicates how much of their time in bed was spent sleeping.

“Adverse fetal environment may have lifelong influences on health and behavior,” principal investigator Katri Räikkönen, PhD, told the AASM.

The CDC reports that drinking alcohol during pregnancy can cause a baby to be born with birth defects. About 1 in 12 pregnant women in the U.S. reports alcohol use.

Size at birth also was related to childhood sleep problems; lower weight and shorter length were associated with lower sleep efficiency. The authors report that small body size at birth may reflect disturbances in the fetal environment.

One finding surprised the authors: There was no link between prenatal tobacco exposure and sleep at 8 years of age.

Learn more about sleep and pregnancy on SleepEducation.com.

Do the Babies of Depressed Moms Have More Sleep Disturbances?

A small study in the journal Sleep examined the sleep of babies born to mothers who struggle with depression.

Results show that these babies are more likely to have disturbed sleep at 2 weeks of age. These sleep problems remain present at the age of 6 months.

The study involved 18 healthy, full-term babies. Seven “low-risk” infants were born to women with no history of depression. Eleven “high-risk” babies were born to women diagnosed with depression or with high levels of depression symptoms.

Babies born to depressed moms took an hour longer to fall asleep at night. They also had shorter periods of sleep. Their average total sleep time during a 24-hour period was similar to the “low-risk” babies. But their nightly sleep was 97 minutes shorter; during the daytime they had more sleep episodes of a shorter average duration.

Are these sleep problems directly linked to the mother’s depression? Is it the mother’s hormone levels that affect the infant’s sleep? This is still unclear, study author Roseanne Armitage, PhD, told the AASM.

“Whether it is maternal hormones that ‘cause’ the sleep problems in infants is not yet known,” she said. “It could be genetic, hormonal, or both.”

But Armitage thinks that it is possible to improve the sleep of babies born to depressed moms. A behavioral or environmental intervention may be helpful.

Learn more about how to help your infant sleep better on SleepEducation.com.

Mother’s Day: Restless Legs, Sleepless Moms

Every mom deserves a good night of sleep for Mother’s Day. But good sleep can be especially hard to come by for women with restless legs syndrome.

RLS involves a strong, almost irresistible urge to move your legs. This urge gets worse at night and eases in the morning. The need to move your legs increases when you lie or sit still. Temporary relief can be found by walking or moving the legs.

Often RLS also involves an uncomfortable feeling in the legs. It may be hard to describe what this feels like. It might be a burning, prickling, itching or tingling sensation.

RLS can have a severe effect on your sleep. It may prevent you from falling asleep. It also may keep you from returning to sleep if you wake up during the night.

Women are more likely than men to have RLS. It also is common during pregnancy.

There are many drugs that can help treat RLS. Mirapex and Requip are both FDA-approved for RLS. Reuters reported recently that Lyrica also may be a helpful treatment for RLS.

Last week the Dallas Morning News shared one woman’s story of what it’s like to suffer from RLS. “It's as if everything from the waist down wants to dance when everything from the waist up wants to sleep,” she says.

You can get help for RLS from an AASM-accredited sleep center near you.