A Comparison of Sleep and Daytime Sleepiness in Depressed and Non-Depressed Mothers during the Early Postpartum Period

Abstract

研究顯示睡眠缺損是產後憂鬱的主要徵象，由於缺乏探討產後初期睡眠和憂鬱之相關研究，本研究比較憂鬱及非憂鬱之產婦的夜間睡眠與日間嗜睡狀態，並探討產後憂鬱可能的危險因子。本研究對象為163位成年初產婦，於產後13-20天進行結構式問卷調查。結果顯示：憂鬱組的睡眠品質總分（含七個睡眠向度）顯著地較非憂鬱組更差，僅有「使用睡眠藥物」此向度的組間差異未達統計顯著水准。相對於非憂鬱組媽媽，憂鬱組媽媽有較差的睡眠品質、低睡眠效率、較多困擾、及較多日間功能受損。憂鬱組自評嗜睡程度較非憂鬱組為高，其自覺照顧嬰兒的能力因嗜睡而受影響的頻率也較非憂鬱組高。研究發現支持產婦產後憂鬱與睡眠品質低落之間的相關，而憂鬱組媽媽的睡眠品質低落是一多向度的現象，而非單純只是睡眠不足而已。

Taiwanese mothers have identified insufficient sleep as a major manifestation of postpartum depression. Few studies have thoroughly examined the relationship between sleep and depression during the early postpartum period, however. The objectives of this study were to compare the characteristics of both the postpartum sleep and daytime sleepiness of depressed first-time mothers and of their non-depressed counterparts, and to determine the factors that significantly increased mothers’ risks of being depressed. A non-probability sample of 163 first-time mothers completed a questionnaire between the 13th and 20th days of the postpartum period. The Center of Epidemiological Studies- Depression and Pittsburgh Sleep Quality Index were used to measure mothers’ experiences of depression symptoms and sleep. Daytime sleepiness was estimated in four ways, derived from the Roy Adaptation Model. The results indicated that the depressed mothers had poorer sleep quality than the non-depressed mothers, slept less efficiently, reported more sleep disturbances, and exhibited more daytime dysfunctions. Mothers who frequently perceived their daytime sleepiness to be affected by infant-care performance were more likely to be depressed. The study’s findings support the view that there is a connection between depression and poor sleep among postpartum mothers in Taiwan, and indicate that depressed mothers’ experiences of poor sleep are multi-faceted, and not simply a matter of insufficient sleep.