Maternal vulnerability to insomnia: Relationship with poor newborn sleep and peripartum psychopathology

Purpose: Sleep reactivity, defined as the degree to which sleep is disrupted due to exposure to stress, serves as a distinctive trait and an indicator of an individual's vulnerability to insomnia. While insomnia may be a risk factor for maternal psychopathology, we aimed to study maternal insomnia vulnerability and its relationship with perinatal psychopathology and newborn sleep. Method: Pregnant women were recruited during their last routine assessment before being hospitalized for delivery at the Gynecological Unit of the University Hospital of Ferrara and Udine, Italy. The assessment included baseline evaluation (T0), and evaluations at 1 months (T1) in the postpartum period with specific questionnaires for insomnia vulnerability such as the Ford Insomnia Response to Stress Test (FIRST), Insomnia Disorder such as Sleep Condition Indicator (SCI), mood and anxiety symptoms such as Edinburgh Postnatal Depression Scale (EPDS), Mood Disorder Questionnaire (MDQ), State-Trait Anxiety Inventory (STAI) and newborn sleep Disturbance Scale for Children (SDSC). Results: At T0, 151 pregnant women were included. Elevated sleep reactivity affected the 36.4 % at T0. Women with elevated prenatal sleep-reactivity were significantly more affected by prenatal, insomnia, anxiety and mood symptoms. Prenatal elevated sleep reactivity predicted post natal insomnia (OR 4.50,p = 0.014), anxiety (OR 3.44, p = 0.002) and depressive symptoms (OR. 4.45, p = 0.008), It also predicted poor newborn sleep (OR 3.43, p = 0.032). Conclusions: Maternal vulnerability to insomnia is an important prenatal factor that may contribute to concurrent and postpartum psychopathology and to poor newborn sleep. Findings may suggest a potential hereditary aspect of insomnia in newborns born to women with insomnia disorder and exhibiting elevated sleep reactivity.