Sleepless and depressed: postpartum depression

July 15, 2009 by  
Filed under DEPRESSION

motherly_lovePostpartum depression (PPD): only mothers have the bad luck of going through such an ordeal. Fortunately, in most cases, PPD is not permanent but rather reversible. Tell me about it. I’ve had it myself – an extended one actually because I had twins. A case of a double dose of stress perhaps?

Anyway, many hypotheses have been put forward as to what causes depression in postpartum women. Latest research suggests that sleep disturbances may play a key role in PPD. In a study of 2,830 Norwegian mothers, the following results were reported:

  • 60% of the participating women admitted to be suffering from sleep deprivation. Of these, 16.5 suffered from depressive symptoms.
  • 21% of women with PPD reported to have been already depressed during pregnancy.
  • 46% of those with PPD reported to have had at least 1 episode of depression before getting pregnant.
  • Average nightly sleep duration was reported to be 6.5 hours.
  • Sleep efficiency was 73%.

It seems that PPD is not only due to poor sleep quality but to a history of depression before and during pregnancy. Other factors such as a bad relationship and stressful life events may also play a role. However, tiredness and lack of sleep can aggravate the depressive symptoms. The association between depression and poor sleep was observe to set in about four months after delivery.

Experts find it is important to find out whether the depression causes the sleep disturbances or whether it is the tiredness that causes the depression. To complete the vicious cycle, babies of moms with PPD also tend to suffer from sleep disturbances from age two weeks to six months, according to another research.

According to lead researcher of the Norwegian study Dr. Karen Dørheim, psychiatrist at Stavanger University Hospital in Norway,

“It is important to ask a new mother suffering from tiredness about how poor sleep affects her daytime functioning and whether there are other factors in her life that may contribute to her lack of energy. There are also helpful depression screening questionnaires that can be completed during a consultation. Doctors and other health workers should provide an opportunity for postpartum women to discuss difficult feelings.”

In addition, the researchers also looked at the factors that affect sleep quality in postpartum moms and they’ve identified the following to cause poor sleep quality:

  • depression
  • history of sleep problems
  • having a younger or male infant
  • being a first time mother
  • not exclusively breastfeeding

Postpartum sleep quality seems to be better when the baby sleeps in another room.

Sleep and stroke – where’s the connection?

August 12, 2008 by  
Filed under HEART AND STROKE

In a previous post, I’ve discussed about how lack of sleep can adversely affect women’s hearts much more than men’s.

In another study on sleep, too much or too little sleep seems to increase the risk of ischemic stroke among postmenopausal women.

The researchers conducted this prospective study involving 93,175 postmenopausal women aged 50 to 79 years in order to examine link between risk of ischemic stroke and self-reported sleep duration. Ischemic stroke is the most common type of stroke and it occurs when an artery supplying blood to the brain is blocked. The participants were followed up for an average time of 7.5 years, during which 1,166 cases of ischemic stroke were reported among the study participants. 8.3% of the women reported getting less than 6 hours of sleep per night while 4.6% get more than 9 hours of nightly sleep.

Analysis of the data showed that women who slept seven hours a night had lowest risk for stroke. In comparison,

women who slept nine hours or more had a 70% higher risk of stroke. Those who slept less than six hours per night had a 14% higher risk of stroke. These findings took into account age, race, socioeconomic status, depression, smoking, exercise, use of hormone therapy, and cardiovascular risk factors such as past history or stroke or heart attack, high blood pressure, and diabetes.”

The health risks of lack of sleep are quite well-known but very little is known about the effects of getting too much sleep. This study showed surprising results wherein too much sleep in linked to higher risk of stroke than too little sleep. However, more women reported getting too little sleep than getting too much sleep (8.3 vs. 4.6%). Therefore, the health risks of lack of sleep should not be underestimated.

It is not clear why longer sleep duration increases the risk for stroke and this should be addressed by in future studies. For example, such link should also be investigated among younger women and men.

In another study, midlife stroke has been found to be more common among women aged 45 to 54 years old than men of the same age group. High blood pressure, high cholesterol levels, and weight problems were all identified as possible risk factors. Sleeping pattern would probably be added to this list.

Poor sleep among women seems to be very common and has been linked to physiological and psychological causes. Recent studies have shown that sleeping problems especially increase during the menopausal transition. The American Academy of Sleep Medicine (AASM) is a good source of information about sleep.

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Sleepless nights are hard on women’s hearts

June 24, 2008 by  
Filed under HEART AND STROKE

Poor sleep is associated with increased risk for having type 2 diabetes and heart disease. And when it comes to lack of sleep, women’s cardiovascular health suffer the most. A recent study by researchers at Duke University Medical Center shows that women’s hearts and vascular systems are more sensitive to sleep deprivation than men’s.

The results of the study were based on data gathered from 210 healthy middle-aged women and men. All participants had no history of diagnosed sleep disorders. They were all non-smokers, and were not on daily medications.

The participants were categorized as good sleepers and poor sleepers. Poor sleepers are those having problems falling asleep and having frequent disruptions in sleep. 40% of the participants were poor sleepers and these have a much higher risk for cardiovascular disease than the good sleepers. However, poor sleepers who are females exhibited higher levels of C-reactive protein and interleukin-6 and higher levels of insulin then male poor sleepers. C-reactive protein and interleukin-6 are biomarkers for inflammation which are linked to increased risk of heart disease. Insulin levels are biomarkers for type 2 diabetes.

The time it takes to fall asleep seems to be a big factor. Female participants who take a half hour or more to fall asleep had the highest risk.

In a survey by the National Sleep Foundation, 60 % of the female respondents report that they only get a good night’s sleep a few nights a week. 43 % report sleepiness during daytime and this can interfere with their normal daily activities.

There are many reasons why people have sleep shortage. For many women, having children is the main reason for sleep deprivation. As mom of twins, I knew how sleep deprivation sapped me of energy and pushed me into a prolonged postpartum depression. Although that was 5 years ago and my sleeping patterns have since improved, I still suffer from sleep disruptions each time my children awake at night to go to the bathroom. I guess it’s one of the hazards of motherhood.

“We found that for women, poor sleep is strongly associated with high levels of psychological distress, and greater feelings of hostility, depression and anger. In contrast, these feelings were not associated with the same degree of sleep disruption in men.”

according to head researcher Edward Suarez.

Other causes of sleeplessness in women may be also biological and mainly hormonal in nature. They may include menstrual cramps, hot flashes and irregular menstrual cycles.

In another post, I will be tackling the topic of “sleep hygiene habits.” So if you can’t sleep, stay tuned!

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.