Poor Sleep During Pregnancy as Risk Factor for Post-partum Stress and Mental Health

Conditions studied

Postpartum Depression, Insomnia, Stress

About this study

Improving maternal mental health is a worldwide health priority. Nevertheless, several scientific sources highlighted lack of empirical data which could drive clinical practice. The present project addresses psychobiological mechanisms leading to peripartum mental disorders. It focuses on one key risk factor for psychopathology, which is poor sleep continuity. The project aims to describe the link between maternal poor sleep quality and the cascade of events which may enhance vulnerability to stress and risk for mental disorders and to evaluate the efficacy of an online automated psychological prenatal intervention directed to sleep problems in preventing these negative outcomes.

Interventions

• Behavioral: Improving sleep health and resilience during pregnancy — Weekly sessions include: a video clip (ca. 20 min) and a pdf; short questions on participants' experience related to the session's content; brief feedback questions on session's contents. Participants will have weekly opportunity for private online chats with a clinician. Sessions' contents: 1. Aims of the intervention; introducing the physiological regulation of sleep, sleep health and how sleep changes during pregnancy; 2. Psychological regulation of sleep and the impact of behaviors on sleep regulation; introducing the basics of CBT-I behavioral techniques; 3. Cognitive factors maintaining sleep difficulties; introducing cognitive techniques; 4. Emotional factors maintaining sleep difficulties and on the bidirectional association between sleep and emotions; introducing emotion regulation techniques; 5. Sleep in the postpartum and the development of sleep regulation in children; 6. Relapse prevention and focus on acquired skills and how to prioritize sleep.
• Behavioral: Information on pregnancy-related issues — Each session will include: video clip (ca. 20 minutes) on aspects related to pregnancy and sleep; brief feedback questions. Participants in the placebo intervention will not be given specific indications on skills or techniques for sleep difficulties and will not have access to the weekly chat with the clinician. Sessions will cover the following contents: Session 1: phases of pregnancy; Session 2: sleep disorders; Session 3: nutrition and physical activity during pregnancy; Session 4: childbirth; Session 5: psychophysical development of the child in the first three years of life; Session 6: synthesis of previous sessions.

Primary outcomes

• Stress reactivity (Twice a day (morning and evening) once at baseline; after 6 weeks from baseline; 6 months post-partum)
• Sleep efficiency (One week at baseline; after 6 weeks from baseline; 6 months post-partum)
• Depressive symptoms (Baseline; after 6 weeks from baseline; after 12 weeks from baseline; 1-to-2-week after birth; 3 months post-partum; 6 months post-partum)
• Insomnia symptoms (Baseline; after 6 weeks from baseline; after 12 weeks from baseline; 1-to-2-week after birth; 3 months post-partum; 6 months post-partum)
• Anxiety symptoms (Baseline; after 6 weeks from baseline; after 12 weeks from baseline; 1-to-2-week after birth; 3 months post-partum; 6 months post-partum)
• Valence of affective states (Baseline; after 6 weeks from baseline; after 12 weeks from baseline; 1-to-2-week after birth; 3 months post-partum; 6 months post-partum)
• Arousal of affective states (Baseline; after 6 weeks from baseline; after 12 weeks from baseline; 1-to-2-week after birth; 3 months post-partum; 6 months post-partum)
• Emotion regulation (Baseline; after 6 weeks from baseline; 6 monhts post-partum)

Eligibility information

Study locations

• Department of Biomedical and Neuromotor Sciences, Physiology campus, University of Bologna, Bologna, Italy, Bologna, Bologna 40126 Italy
• Department of Human Sciences, Guglielmo Marconi university, Rome, Rome 00193 Italy