Abstract Introduction Perinatal sleep is critical to support maternal health, but evidence assessing multidimensional sleep changes from pregnancy through the first postpartum year remains limited. This study examined multidimensional sleep health patterns across the perinatal period using six domains: duration, efficiency, timing, regularity, satisfaction, and alertness. Methods A total of 50 participants in the Pregnancy 24/7 Cohort Study and the Postpartum 24/7 Pilot Study wore the Actiwatch Spectrum Plus and completed a sleep diary for 7 consecutive days during the 1st, 2nd, and 3rd trimesters of pregnancy and at 3, 6, and 12 months postpartum. Sleep duration was defined as the interval between sleep onset and sleep offset, and sleep efficiency as the percentage of time spent asleep while in bed. Sleep timing was calculated as the mean sleep midpoint, defined as the halfway point between sleep onset and sleep offset. Sleep regularity was defined as the standard deviation (SD) of the sleep midpoint. Satisfaction and alertness were obtained using single-item questions (subjective sleep quality, daytime dysfunction) from the Pittsburgh Sleep Quality Index. Linear mixed-effects models assessed continuous domains, and chi-square tests evaluated categorical domains, with Tukey-adjusted comparisons. Results Sleep duration, efficiency, and regularity significantly changed across the perinatal period. Duration in the 1st trimester (8.66 hours) was significantly longer than at 6 and 12 months postpartum (8.20-8.21 hours, all p≤007). Efficiency was lowest at 3 months postpartum (85.99%), compared to all pregnancy trimesters (88.00–88.64%, all p≤0.002), but improved progressively across the postpartum year, returning to pregnancy levels by 12 months (87.50%). Regularity at 12 months postpartum (SD=30 minutes) was more consistent than during all pregnancy trimesters (1st: 39 min, p=.018; 2nd: 43 min, p=.012; 3rd: 41 min, p=.004). Timing, satisfaction and alertness showed no significant changes across pregnancy and postpartum. Conclusion Although participants generally demonstrated healthy sleep patterns, notable changes in specific sleep domains were observed. Future studies should examine these patterns in more diverse or higher-risk populations to better understand how multidimensional sleep health changes across the perinatal period, followed by work to identify which domains are most relevant for maternal health outcomes. Support (if any) R01HL153095
Kim et al. (Fri,) studied this question.