Examining the relationship between emotion dysregulation and subjective & objective sleep from late pregnancy to early postpartum

Abstract

The perinatal period is marked by biological/hormonal, physiological, and psychosocial changes that can increase the risk of sleep difficulties and emotion dysregulation (ED). While the relationship between ED and sleep is well-documented, it remains understudied in the perinatal period despite the resulting adverse maternal-infant outcomes. This study aimed to address gaps in our understanding by 1) examining the relationship between ED and sleep longitudinally from late pregnancy to early postpartum, and by 2) using both subjective and objective measures of sleep. 58 participants were assessed across three visits during their third trimester of pregnancy, at 1-3 weeks, and at 6-12 weeks postpartum. ED was assessed using the Difficulties In Emotion Regulation Scale (DERS) at visit 1. Participants wore actigraphs for two week periods to obtain objective sleep data at each timepoint, including total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), sleep onset latency (SOL), and awakenings. Subjective sleep quality was examined using the Pittsburgh Sleep Quality Index (PSQI). Subjective sleep quality differed significantly between high and low ED groups at all visits, where those with high ED experienced worse sleep quality. Significant differences in this direction were also found for SE and WASO at visit 1. Significant positive correlations were found between the awareness subscale of the DERS and subjective sleep quality across visits, along with the strategies subscale at visits 1 and 3. This study provides support for the differential influence of high and low ED on subjective and objective sleep across the third trimester of pregnancy to 1-3 and 6-12 weeks postpartum, where those with higher ED display a trend of increased sleep difficulties across visits. With its use of a longitudinal design and subjective and objective sleep measures, this study provides novel insights into the ED – sleep relationship perinatally.