Sleep Quality and Quantity in Low-Income Postpartum Women.

The sample was a convenience sample from two Midwest postpartum units. 72% were African-American and 94% reported WIC assistance, so results may not apply to other postpartum groups. Women with sleep disorders, psychiatric disorders, sleep medications, current intimate partner violence, or an older child who did not sleep through the night were excluded. Studies in similar populations note 25 to 40% score in a depression referral range, so this sample may underestimate depression. Attrition was high: 183 enrolled, but only 62 completed week 24, and there were no retention activities between weeks 12 and 24. Actigraphy data were incomplete for 15% of the 119 participants who completed both recordings. Complete data were available for 102 at week 4 and 99 at week 8. Some actigraph non-use reflected severe stress or loss, including a participant whose infant died suddenly and unexpectedly. This was a descriptive, non-experimental study, so it cannot show that sleep advice or other strategies improved sleep, fatigue, or depression. Actigraphy sleep times did not correlate with subjective sleep or fatigue scores, so self-report and measured sleep may tell different things.

The authors declared no conflicts of interest.

Do not read the lower sleep-disturbance and fatigue scores as proof that sleep duration improved. Actigraphy showed 5.5 hours at week 4 and 5.4 hours at week 8, with no change in total sleep, and 16.4% exceeded the depression referral threshold at week 24.