Background
Poor sleep during pregnancy is very common and is associated with increased risk of adverse maternal and infant outcomes. Maternal psychosocial stress has been found to negatively impact sleep. The recent outbreak of COVID-19 has exposed many individuals to an unprecedented level of stress, that will continue for an unknown period of time. Studies are showing that all these factors may not only increase levels of stress, but also influence sleep health.
Methods
From March 2020-May 2021, participants were recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) study at Columbia University. Survey data on maternal depression (PHQ-9), perceived stress (PSS), COVID-related stress, and sleep health (Pittsburgh Sleep Quality Index, PSQI) were collected. For this analysis, we excluded mothers identified as depressed based on PHQ9. Regressions analyses were implemented to estimate the associations between PSS and COVID-related stress and multiple domains of sleep, accounting for covariates (maternal age, education, gestational age covid infection in pregnancy, time of the pandemic).
Results
Our sample consisted of N=155 women; Gestational age at assessment: 30.6±5.8 weeks; Age: 32.2±5.0 years; non-Hispanic White=66, non-Hispanic Black=12, Hispanic=56, Asian=16, Other=5; 69% 4-year college/graduate degree. Mean PSS was 18.3±7.0 and COVID-related stress was 3.9±1.6. COVID-related stress negatively affected subjective sleep quality (β=0.3±0.1, p<0.01), latency (β=0.4±0.1, p<0.001) and sleep disturbances (β=0.5±0.2, p=0.003). Increased PSS negatively affected sleep duration (β=0.09±0.2, p<0.001), efficiency (β=0.08±0.02, p<0.001), and daytime dysfunction (β=0.08±0.03, p=0.01).
Conclusions
Our results suggest that stress related to the current COVID-19 pandemic is uniquely affecting maternal sleep health during pregnancy.
Funding Source
R01MH126531; Eunice Kennedy Shriver National Institute of Child Health and Human Development under grant number P2CHD058486, awarded to the Columbia Population Research Center
Keywords
Sleep, Perceived Stress, COVID-19, Pregnancy