Women’s attitudes and beliefs regarding sleep during pregnancy are significant predictors of sleep disruption after delivery.
RT’s Three Key Takeaways:
- Predictive Beliefs: A study of 432 women found that expectations of poor sleep during pregnancy were significant predictors of actual postpartum sleep quality, regardless of a patient’s medical or psychiatric history.
- Anxiety Correlation: For women who anticipated the highest levels of sleep disruption, postpartum anxiety further decreased both objective and subjective sleep quality.
- Early Intervention: Identifying and addressing sleep-related attitudes during prenatal care could provide healthcare providers with a target to prevent postpartum sleep disorders before they emerge.
Pregnant women’s expectations about postpartum sleep predicted their actual sleep quality after delivery, outweighing prior sleep and psychiatric history, according to a study presented at the Sleep 2026.
Data from the study showed that 70% of pregnant women (301 of 432) expected poor sleep in the postpartum period. The level of predicted sleep disruption during pregnancy was a significant predictor of postpartum sleep concerns. Among first-time pregnant women without prior healthcare concerns, those who predicted greater sleep disturbance had significantly more disrupted sleep postpartum, as measured by both actigraphy and self-reports.
“Most pregnant women in our sample anticipated poor postpartum sleep before it occurred, and it was striking that those expectations predicted worse sleep outcomes even after accounting for factors such as prior sleep disorders, psychiatric history, and number of previous births,” said Sammy Dhaliwal, a clinical health psychologist and research fellow with the Department of Obstetrics and Gynecology in the Perelman School of Medicine at the University of Pennsylvania. “This suggests that attitudes and beliefs about sleep during pregnancy may represent a modifiable target for early intervention before postpartum sleep problems emerge.”
According to the American Academy of Sleep Medicine, sleep is essential to health, requiring adequate duration, good quality, appropriate timing, and regularity. While sleep disturbance affects an estimated 60% to 80% of postpartum women and is associated with increased risk for depression and anxiety, it is often regarded as an expected part of the postpartum experience.
The study enrolled 432 pregnant women at approximately 24 weeks of gestation. Participants completed measures of their attitudes and beliefs about postpartum sleep, current sleep quality using the Pittsburgh Sleep Quality Index, and mood using validated depression and anxiety scales.
Assessments were repeated at 6, 12, and 24 weeks postpartum. A subset of 49 women also wore wrist actigraphy at 6 to 8 weeks postpartum to provide an objective measure of sleep. Among women who predicted the worst sleep quality, higher postpartum anxiety significantly worsened objective and subjective sleep quality, independent of anxiety levels during pregnancy.
Dhaliwal noted the findings point to two potential intervention targets: addressing sleep-related beliefs during pregnancy and treating postpartum anxiety.
“Postpartum sleep disruption is often treated only after problems develop, but our findings suggest there may be an opportunity to intervene earlier during pregnancy,” said Dhaliwal. “Addressing sleep-related beliefs and postpartum anxiety during prenatal and postpartum care may help improve sleep and emotional well-being in new mothers.”
