Postpartum mothers of twins have significant sleep restriction, depressive symptoms

June 09, 2008

WESTCHESTER, Ill. - Postpartum mothers of twins have significant sleep restriction and depressive symptoms, according to a research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, authored by Elizabeth Damato, PhD, of Case Western Reserve University in Cleveland, Ohio, focused on 14 mothers of twins that were, on average, delivered three-and-a-half weeks early. Measures included actigraphy, sleep diaries, and standardized instruments for fatigue, sleep quality, and depression.

According to the results, by the time the twins reached full-term, mothers were sleeping an average of 5.4 hours in a 24-hour period, with over 70 percent reporting less than six hours of sleep. Furthermore, the sleep was very fragmented, with an average of 15.1 sleep episodes daily, each lasting an average of 22.4 minutes. Almost half of mothers reported mild to severe depressive symptoms. By the time the twins had been home for eight weeks, average sleep duration had only improved marginally to 5.6 hours daily, although this was achieved in fewer sleep episodes lasting an average of 31.8 minutes each. The percentage of women with depressive symptoms decreased to less than 25 percent. Mothers reported improved sleep quality and decreased fatigue levels over time.

"As primary caregivers for families, mothers caring for twins experience enormous workload, extreme exhaustion, and limited time to meet their own needs," said Dr. Damato. "Additionally, mothers of twins are likely to be caring for babies that are premature. Premature infants are more fragile, require more vigilant care, and are more difficult to feed than full term infants. Meeting the increased demands of two premature infants places mothers at risk for sleep deprivation. Recent evidence suggests that sleep deprivation and the resultant fatigue are related to the development of postpartum depression. Postpartum depression is known to have negative effects on the quality of mother-child interactions and on the child's biological and behavioral development."

It is recommended that women get between seven and eight hours of nightly sleep.

Although the effectiveness of sleep strategies has not been formally evaluated for mothers of twins, the following tips are offered for new mothers on how to get a good night's sleep: Those who suspect that they might be suffering from a sleep disorder are encouraged to consult with their primary care physician or a sleep specialist.
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More information on "women and sleep" is available from the AASM at http://www.SleepEducation.com/Topic.aspx?id=67.

The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.

More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

American Academy of Sleep Medicine

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