David A Kalmbach1, Philip Cheng2, Jason C Ong3, Jeffrey A Ciesla4, Sheryl A Kingsberg5, Roopina Sangha6, Leslie M Swanson7, Louise M O'Brien8, Thomas Roth2, Christopher L Drake2. 1. Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA. Electronic address: dkalmba1@hfhs.org. 2. Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA. 3. Departments of Neurology and Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA. 4. Department of Psychological Sciences, Kent State University, Kent, OH, 44240, USA. 5. Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, 44106, USA. 6. Department of Obstetrics & Gynecology, Henry Ford Health System, Detroit, MI, 48202, USA. 7. Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA. 8. Departments of Obstetrics & Gynecology and Neurology, Ann Arbor, MI, 48105, USA.
Abstract
BACKGROUND: Sleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy. METHODS: In this study, 267 pregnant women were recruited from obstetric clinics and completed online surveys on sleep, depression, and nocturnal rumination. RESULTS: Over half (58.4%) of the sample reported clinical insomnia on the Insomnia Severity Index, 16.1% screened positive for major depression on the Edinburgh Postnatal Depression Scale (EPDS), and 10.1% endorsed suicidal ideation. Nocturnal rumination was more robustly associated with sleep onset difficulties than with sleep maintenance issues. Depressed women were at greater odds of sleep onset insomnia (OR = 2.80), sleep maintenance insomnia (OR = 6.50), high nocturnal rumination (OR = 6.50), and negative perinatal-focused rumination (OR = 2.70). Suicidal ideation was associated with depression (OR = 3.64) and negative perinatal-focused rumination (OR = 3.50). A four-group comparison based on insomnia status and high/low rumination revealed that pregnant women with insomnia and high rumination endorsed higher rates of depression (35.6%) and suicidal ideation (17.3%) than good-sleeping women with low rumination (1.2% depressed, 4.9% suicidal). Women with insomnia alone (depression: 3.9%, suicidal: 5.9%) or high rumination alone (depression: 10.7%, suicidal: 7.1%) did not differ from good-sleeping women with low rumination. CONCLUSIONS: High rumination and insomnia are highly common in mid-to-late pregnancy and both are associated with depression and suicidal ideation. Depression and suicidal ideation are most prevalent in pregnant women with both insomnia and high rumination. CLINICALTRIALS. GOV IDENTIFIER: NCT03596879.
BACKGROUND: Sleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy. METHODS: In this study, 267 pregnant women were recruited from obstetric clinics and completed online surveys on sleep, depression, and nocturnal rumination. RESULTS: Over half (58.4%) of the sample reported clinical insomnia on the Insomnia Severity Index, 16.1% screened positive for major depression on the Edinburgh Postnatal Depression Scale (EPDS), and 10.1% endorsed suicidal ideation. Nocturnal rumination was more robustly associated with sleep onset difficulties than with sleep maintenance issues. Depressed women were at greater odds of sleep onset insomnia (OR = 2.80), sleep maintenance insomnia (OR = 6.50), high nocturnal rumination (OR = 6.50), and negative perinatal-focused rumination (OR = 2.70). Suicidal ideation was associated with depression (OR = 3.64) and negative perinatal-focused rumination (OR = 3.50). A four-group comparison based on insomnia status and high/low rumination revealed that pregnant women with insomnia and high rumination endorsed higher rates of depression (35.6%) and suicidal ideation (17.3%) than good-sleeping women with low rumination (1.2% depressed, 4.9% suicidal). Women with insomnia alone (depression: 3.9%, suicidal: 5.9%) or high rumination alone (depression: 10.7%, suicidal: 7.1%) did not differ from good-sleeping women with low rumination. CONCLUSIONS: High rumination and insomnia are highly common in mid-to-late pregnancy and both are associated with depression and suicidal ideation. Depression and suicidal ideation are most prevalent in pregnant women with both insomnia and high rumination. CLINICALTRIALS. GOV IDENTIFIER: NCT03596879.
Authors: Vivek Pillai; Lindsey A Steenburg; Jeffrey A Ciesla; Thomas Roth; Christopher L Drake Journal: J Psychosom Res Date: 2014-05-20 Impact factor: 3.006
Authors: David A Kalmbach; Philip Cheng; Louise M O'Brien; Leslie M Swanson; Roopina Sangha; Srijan Sen; Constance Guille; Andrea Cuamatzi-Castelan; Alasdair L Henry; Thomas Roth; Christopher L Drake Journal: Sleep Med Date: 2020-03-21 Impact factor: 3.492
Authors: Maristella Lucchini; Louise M O'Brien; Linda G Kahn; Patricia A Brennan; Kelly Glazer Baron; Emily A Knapp; Claudia Lugo-Candelas; Lauren Shuffrey; Galit Levi Dunietz; Yeyi Zhu; Rosalind J Wright; Robert O Wright; Cristiane Duarte; Margaret R Karagas; Pakkay Ngai; Thomas G O'Connor; Julie B Herbstman; Sean Dioni; Anne Marie Singh; Carmela Alcantara; William P Fifer; Amy J Elliott Journal: Sleep Date: 2022-09-08 Impact factor: 6.313
Authors: David A Kalmbach; Daniel J Buysse; Philip Cheng; Thomas Roth; Alexander Yang; Christopher L Drake Journal: Sleep Med Date: 2019-11-14 Impact factor: 3.492