Sleep-Wake Disorders

Insomnia in Late Pregnancy Associated With Perinatal Anxiety

Abigail Nover
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Pregnant woman feeling pain in her belly lying in bed with insomnia at night. The concept of pregnancy and health
Gestational insomnia is associated with anxiety symptoms, both during pregnancy and after childbirth.

Insomnia during pregnancy is associated with perinatal anxiety, according to research findings published in the Journal of Affective Disorders.

Because few studies have examined perinatal anxiety and postpartum anxiety (PPA) triggers, researchers investigated the prevalence of perinatal anxiety disorders and their association with insomnia during late pregnancy and anxiety before and after childbirth.

The longitudinal population-based study was part of the Akershus Birth Cohort in Norway. Researchers analyzed data from 1563 participants, utilizing birth records and questionnaires conducted from gestational weeks 17 and 32, as well as postpartum week 8. The Hopkins Symptom Check List-25 was used to measure perinatal anxiety symptoms, the Mini-International Neuropsychiatric Interview to assess anxiety disorder symptoms, and the Bergen Insomnia Scale was used to measure insomnia.

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On average, 10.2% of perinatal women reported symptoms of at least one anxiety disorder. The prevalence of obsessive-compulsive disorder was significantly higher after delivery (4.2%) than during pregnancy (2.5%). Regression analyses, adjusted for psychosocial and reproductive variables, revealed that insomnia during pregnancy was associated with PPA symptoms. When depression variables were included in the analysis, the association was weaker, suggesting that gestational insomnia could be an indicator of a mood disorder.

The findings showed a high prevalence of anxiety disorders during the perinatal period, and researchers stated, “Health professionals should be aware that women with gestational insomnia may have an increased risk of mood and anxiety disorders.” They added that providers also should be aware of the obsessive-compulsive symptoms and the vulnerability in women with a history of sexual abuse to develop PPA.

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Researchers noted that future research should assess the association between insomnia during pregnancy and PPA and the extent to which treatment of anxiety, depression, and insomnia in pregnancy can help prevent PPA.

The study was limited by a lack of representation of immigrant and single women in the sample.

Reference

Osnes RS, Roaldset JO, Follestad T, Eberhard-Gran M. Insomnia late in pregnancy is associated with perinatal anxiety: a longitudinal cohort study [published online January 28, 2019]. doi:https://doi.org/10.1016/j.jad.2019.01.027