0954 Associations Between Sleep Duration and Timing and Postpartum Anxiety Symptoms

Abstract Introduction Postpartum anxiety is understudied and underdiagnosed in postpartum women, despite being more common than postpartum depression. Given associations between postpartum anxiety and adverse maternal and infant outcomes, it is crucial to identify patterns and predictors of postpartum anxiety. We examined the associations between sleep duration and timing and postpartum anxiety over 6 months following delivery. Methods Pregnant women (n=147; 30-39 weeks) with a history of depression completed the Pittsburgh Sleep Quality Index (PSQI), Edinburgh Postnatal Depression Scale, and Generalized Anxiety Disorder Scale-7 monthly following delivery for 6 months. Sleep duration and timing were extracted from the PSQI. Sleep timing was calculated as the midpoint between sleep onset and offset. In a multilevel model, sleep duration and timing were person-mean centered at level 1 (month level) and grand-mean centered at level 2 (participant level). Level 1 included main effects of time, sleep duration and timing, and interactions between time and person-mean centered sleep duration and timing and time and grand-mean centered sleep duration and timing. Level 2 included main effects of sleep duration and timing. Depression symptoms were included as a covariate at both levels. Results The intraclass correlation for anxiety symptoms was .46, supporting the use of a multilevel model. Anxiety symptoms increased over time (p.001). Months with shorter sleep duration were associated with higher concurrent anxiety symptoms (p.001). The effect of sleep duration on anxiety symptoms varied over time, such that those with shorter sleep duration reported higher anxiety symptoms than those with longer sleep duration in early postpartum months, whereas anxiety symptoms increased during later postpartum months regardless of sleep duration. Sleep timing was not significantly associated with anxiety symptoms (p.05). Conclusion Postpartum anxiety increased over time, suggesting such symptoms are not transient features of the immediate postpartum period and highlighting the need to identify predictors. Shorter sleep duration may signal risk for elevated postpartum anxiety on a monthly timescale, particularly during early postpartum months. Treatments aimed at promoting sleep to improve postpartum anxiety may be most effective if targeted at early postpartum months. Future research should replicate these findings with objective sleep measures. Support (if any) Happiest Baby, Inc.; NIH T32 HL149646