Sleep and perinatal mood disorders: a critical review

Sleep and perinatal mood disorders: a critical review

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J Psychiatry Neurosci 2005;30(4):247-56

Lori E. Ross, PhD; Brian J. Murray, MD; Meir Steiner, MD, PhD

Ross — Women’s Mental Health and Addiction Research Section, Centre for Addiction and Mental Health; Murray — Division of Neurology, Sunnybrook and Women’s College Health Sciences Centre, Toronto; Steiner — Departments of Psychiatry and Behavioural Neurosciences and of Obstetrics and Gynecology, McMaster University, and Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, Ont.

Abstract

Pregnancy and the postpartum period are recognized as times of vulnerability to mood disorders, including postpartum depression and psychosis. Recently, changes in sleep physiology and sleep deprivation have been proposed as having roles in perinatal psychiatric disorders. In this article we review what is known about changes in sleep physiology and behaviour during the perinatal period, with a focus on the relations between sleep and postpartum “blues,” depression and psychosis and on sleep-based interventions for the treatment and prevention of perinatal mood disorders. The interaction between sleep and perinatal mood disorders is significant, but evidencebased research in this field is limited. Studies that measure both sleep and mood during the perinatal period, particularly those that employ objective measurement tools such as polysomnography and actigraphy, will provide important information about the causes, prevention and treatment of perinatal mood disorders.

Résumé

Il est reconnu que les femmes sont vulnérables aux troubles de l’humeur, y compris la dépression postpartum et la psychose, au cours de la grossesse et en période postpartum. On a posé récemment une hypothèse selon laquelle les changements de la physiologie du sommeil et la privation de sommeil joueraient un rôle dans les troubles psychiatriques périnataux. Ce manuscrit passe en revue les connaissances actuelles au sujet des changements de la physiologie et du comportement du sommeil en période périnatale, avec accent sur le lien entre le sommeil et la dépression des premiers jours du postpartum, la dépression postpartum et la pychose pospartum, ainsi que sur les interventions axées sur le sommeil pour le traitement et la prévention des troubles de l’humeur périnataux. L’interaction entre le sommeil et les troubles de l’humeur périnataux est importante, mais peu de recherches factuelles ont été effectuées dans ce domaine. La réalisation d’études mesurant tant le sommeil que l’humeur au cours de la période périnatale, surtout si elles font appel à des outils de mesure objective comme la polysomnographie et l’actigraphie, produira des données importantes sur les causes, la prévention et le traitement des troubles de l’humeur périnataux.


Medical subject headings: depression, postpartum; pregnancy; sleep; sleep deprivation.

Submitted Aug. 27, 2004; Revised Dec. 15, 2004; Accepted Jan. 4, 2005

Acknowledgements: The authors wish to thank Patricia Donoghue for her assistance in the preparation of this manuscript. This work was supported in part by a postdoctoral fellowship to Lori E. Ross from the Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare, Hamilton.

Competing interests: None declared.

Contributors: The review was conceived and critically revised by Dr. Steiner. Drs. Ross and Murray conducted the literature search, reviewed the articles and drafted the review. All authors gave final approval for the article to be published.

Correspondence to: Dr. Lori E. Ross, Women’s Mental Health and Addiction Research Section, Centre for Addiction and Mental Health, 250 College St., Rm. 601A, Toronto ON M5T 1R8; fax 416 979-6811; l.ross@utoronto.ca