Subjective sleep disruption, coping, and anxiety and related symptoms in the perinatal period: findings from a longitudinal study

Study objectives: Anxiety is common during the perinatal period and is associated with adverse maternal and infant outcomes, highlighting a need to identify predictors of perinatal anxiety. Accumulating research implicates sleep disruption in perinatal anxiety and related symptoms, including obsessive-compulsive symptoms. We examined the associations among insomnia symptoms and sleep duration with perinatal anxiety, obsessive beliefs, and obsessive-compulsive symptoms and the moderating role of coping from pregnancy through postpartum. Methods: A sample of 231 women (age_mean = 32.97 ± 4.36 years; 74% white) completed interview and self-report measures of sleep, coping, perinatal anxiety, obsessive beliefs, and obsessive-compulsive symptoms in early and late pregnancy, 6 weeks postpartum, and 6 months postpartum. Multilevel models were used for data analysis. Results: Shorter sleep duration predicted increases in subsequent perinatal anxiety (B = -.63, p < .05) and obsessive beliefs (B = -2.17, p < .05), whereas perinatal anxiety and related symptoms did not predict subsequent sleep disruption (p’s > .05). Those who reported higher insomnia symptoms and shorter sleep duration reported higher perinatal anxiety (B = 1.19, p < .001; B = -3.18, p < .001), obsessive beliefs (B = 3.42, p < .001; B = -11.57, p < .001), and obsessive-compulsive symptoms (B = .69, p < .001; B = -1.94, p < .001) on average. The relation between insomnia symptoms and perinatal anxiety was moderated by coping (B = -.18, p < .01). Conclusions: These findings suggest that sleep disruption is a modifiable risk factor for perinatal anxiety and related symptoms.