The Relationship Between Depression and Daytime Dysfunction from Lack of Sleep in Pregnant Women

Sleep quality and quantity are vital in pregnancy; sleep deficiency poses higher risks of preterm labor, inflammatory cytokines during pregnancy and labor, and postpartum depression. One additional day-to-day risk of sleep loss is daytime dysfunction, or lack of enthusiasm and trouble focusing during daily tasks. A common finding in pregnancy that may impact sleeping patterns and lead to daytime dysfunction is antenatal depression. Antenatal depressive symptoms may manifest as general depressed mood and/or anhedonia. The aim of this study is to examine the contribution of depressive symptoms in pregnant women to daytime dysfunction resulting from poor sleep. In an online survey, 303 pregnant women (gestation weeks μ=28.4wks, SD=8.8wks) completed measures of sleep quantity and quality and mental health. Component 7 of the Pittsburgh Sleep Quality Index (ordinal scale, 0-6) assessed daytime dysfunction by measuring difficulty staying awake (0-3) and lack of enthusiasm (0-3) during daily tasks. The Patient Health Questionnaire-2 (PHQ2) measured anhedonia and depressed mood (ordinal scales, 0-3), comprising overall depressive symptoms (ordinal scale, 0-6). Statistical analyses were performed using SPSS. Of 303 pregnant women, 23.6% reported anhedonia and 21.2% reported depressed mood. There was a positive correlation between the two symptoms (Spearman coefficient=0.396, p\u3c0.01). Three ordinal regressions were performed examining the relationship between PHQ2 measures and daytime dysfunction, controlling for gestational week, diagnosed sleep disorder, snoring, and sleep apnea. Women who reported increased anhedonic symptoms (χ²=50.495, p\u3c0.01), depressed mood (χ²=45.834, p\u3c0.01), and overall depressive symptoms (χ²=66.239, p\u3c0.01) experienced significantly more daytime dysfunction. Depressive symptoms in pregnancy can manifest in various ways, including general depressed mood or anhedonia. Overall, anhedonia, depressed mood, and combined depressive symptoms are all indicators of daytime dysfunction in pregnant women. This study underscores an important negative consequence of depression: diminished daytime functionality and enthusiasm associated with deficient sleep. This information could help further address causes of lack of focus and energy women may face during pregnancy