Maternal sleep trajectories from preconception to postpartum in a population-based cohort: The Generation R next study

Objectives

Sleep is known to change around pregnancy. Yet current studies often do not take into account the multidimensionality of sleep and its changes from preconception to postpartum. Therefore, this study aims to explore maternal multivariate sleep trajectory from preconception to 6 months postpartum and related determinants.

Methods

We included 556 women of the Generation R Next Study with sleep measurements between preconception and postpartum at ≥2 time points, and 850 women with sleep measurements at ≥2 time points from pregnancy onwards. Sleep duration, sleep midpoint, sleep latency, sleep quality, and general sleep disturbance were assessed at preconception (or inclusion), first trimester, third trimester, and 6 months postpartum with the Munich Chronotype Questionnaire and General Sleep Disturbance Scale. We used multivariate and univariate latent class models to identify multidimensional and unidimensional sleep trajectories. Associations of sociodemographic, lifestyle and psychopathological factors with sleep trajectories were assessed with multinomial regressions.

Results

We identified three multivariate sleep trajectories, labelled as ‘good’, ‘average’ and ‘poor’ sleep health. All trajectories were relatively stable over time and with similar sleep duration, but with a different midpoint (03:00, 03:20, 03:40), latency (7.5, 16, 37.5 min), and quality (good, moderate, poor) respectively. Women born outside the Netherlands, with lower socioeconomic status, smoking, using illicit substances, or with depression/anxious symptoms had more poor sleep trajectories.

Conclusion

Maternal sleep trajectories varied in individuals from preconception to postpartum. Comprehensively considering multiple sleep components, rather than a single sleep component, could provide more insights for prevention of poor maternal sleep.