Sleep and daytime sleepiness in first-time mothers during early postpartum in Taiwan

Abstract

The purpose of this study was to describe the characteristics of postpartum sleep and daytime sleepiness and examine the interrelationships among these characteristics in first-time mothers during early postpartum in Taiwan. The relationships among daytime sleepiness, postpartum sleep (i.e., sleep quality, perceived sleep debt), and maternal (i.e., perceived assistance, self-care, infantcare activities, co-sleep practices, and sleep interrupted by the baby) and psychological influencing factors (i.e., perceived stress, depressive symptoms, and health status) were also explored. Four types of daytime sleepiness were derived from the four adaptive modes of the Roy Adaptation Model that also served as a theoretical framework for organizing the relationships among variables of interest. A descriptive correlational design was used in this study with a sample of 189 first-time mothers at 2 to 3 weeks postpartum. The relative contributions of maternal, psychological influencing factors and postpartum sleep on daytime sleepiness were tested by hierarchical multiple regression. The mediator function of postpartum sleep was examined by path analyses without latent variables. Mothers’ nocturnal sleep quality was not ensured by the cultural practice of “doing-the-month.” Mothers still experienced significantly decreased sleep quality and perceived themselves as having about 3 hours of sleep debt. A lack of strong associations among the four types of daytime sleepiness supports the idea that sleepiness is a multifaceted phenomenon. In spite of high levels of daytime sleepiness in two types of sleepiness (physiological and self-concept modes), mothers did not frequently perceive their performance of infant-care was impaired by daytime sleepiness (role function mode). Only the variable of co-sleep practices had statistically significant contributions to both sleep quality and perceived sleep debt, after controlling other predictors. Sleep quality was not a prominent contributor to any of the four types of daytime sleepiness. Mothers’ perception of sleep debt was a significant contributor to one type of daytime sleepiness (interdependence mode). The unique contribution of psychological influencing factors to the explanation of all the four types of daytime sleepiness was statistically significant. The indirect effects of maternal and psychological influencing factors, via postpartum sleep, on the four types of daytime sleepiness were not supported.