Postpartum Sleep in New Mothers and Fathers

Montgomery-Downs,H. E., Stremler, R., Insana, S.P. (2013). Postpartum Sleep in New Mothers and Fathers. The Open Sleep Journal, 6, (Suppl 1: M11), 87-97.

Objectives

1. Evaluate the efficacy of interventions used to improve parent sleep.
2. Review for a high proportion of children reported to co-sleep with their parents and the need for family education regarding safe co-sleeping.
3. Assess if a woman’s decision to breastfeed was based on how it would affect her sleep.

Design: Literature Review                                         

Limitations                                          

1. Only one uncontrolled study examined fathers’ sleep, no studies employed objective measures of sleep, and all studies suffered from methodological and reporting problems.

Findings                                                                                                                                             

1. There is a strong profile of sleep disturbance in postpartum mothers, and to limited extent postpartum fathers, linked to parental mental health and adverse consequences to infant development.         
   
   1. Several studies indicate that sleep disturbance, often associated with birth of child, negatively impacts relationship satisfaction.                                               
   2. Studies support a link between postpartum sleep and depression, which is in turn strongly associated with an increase in negative infant-parent interactions and adverse infant emotional and cognitive outcomes
2. Randomized control trials (RCTs) have been conducted to evaluate the efficacy of sleep interventions aimed at promoting infant sleep in the early postpartum period.                            
   
   1. No statistically significant differences were found on any of the maternal or infant sleep or other outcomes at six or 12 weeks post-partum.                                                         
3. Research consistently challenges the efficacy of standard advice to avoid any type of infant bed sharing; rather, it may be more advantageous to parents to provide education about how to do so safely.
   
   1. The limited research on this topic suggests that infant-parent bedsharing is highly prevalent. One in 10 children between the ages of two weeks and two years sleep exclusively in the parents’ bed, and an additional 5-16% sleep in the parents’ bed at least part of the night.        
4. The impact of infant breastfeeding on maternal sleep does not appear to be deleterious, as once believed
   
   1. One study found that breastfeeding mothers who co- sleep have more sleep than both those who do not co-sleep and formula-feeding mothers.