TY  - JOUR
PY  - 2020//
TI  - Depression and suicidal ideation in pregnancy: exploring relationships with insomnia, short sleep, and nocturnal rumination
JO  - Sleep Medicine
A1  - Kalmbach, David A.
A1  - Cheng, Philip
A1  - Ong, Jason C.
A1  - Ciesla, Jeffrey A.
A1  - Kingsberg, Sheryl A.
A1  - Sangha, Roopina
A1  - Swanson, Leslie M.
A1  - O'Brien, Louise M.
A1  - Roth, Thomas
A1  - Drake, Christopher L.
SP  - 62
EP  - 73
VL  - 65
IS  - 
N2  - BACKGROUND: Sleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy.  METHODS: In this study, 267 pregnant women were recruited from obstetric clinics and completed online surveys on sleep, depression, and nocturnal rumination.  RESULTS: Over half (58.4%) of the sample reported clinical insomnia on the Insomnia Severity Index, 16.1% screened positive for major depression on the Edinburgh Postnatal Depression Scale (EPDS), and 10.1% endorsed suicidal ideation. Nocturnal rumination was more robustly associated with sleep onset difficulties than with sleep maintenance issues. Depressed women were at greater odds of sleep onset insomnia (OR = 2.80), sleep maintenance insomnia (OR = 6.50), high nocturnal rumination (OR = 6.50), and negative perinatal-focused rumination (OR = 2.70). Suicidal ideation was associated with depression (OR = 3.64) and negative perinatal-focused rumination (OR = 3.50). A four-group comparison based on insomnia status and high/low rumination revealed that pregnant women with insomnia and high rumination endorsed higher rates of depression (35.6%) and suicidal ideation (17.3%) than good-sleeping women with low rumination (1.2% depressed, 4.9% suicidal). Women with insomnia alone (depression: 3.9%, suicidal: 5.9%) or high rumination alone (depression: 10.7%, suicidal: 7.1%) did not differ from good-sleeping women with low rumination.  CONCLUSIONS: High rumination and insomnia are highly common in mid-to-late pregnancy and both are associated with depression and suicidal ideation. Depression and suicidal ideation are most prevalent in pregnant women with both insomnia and high rumination. CLINICALTRIALS.  GOV IDENTIFIER: NCT03596879.<p /> <p>Language: en</p>
LA  - en
SN  - 1389-9457
UR  - http://dx.doi.org/10.1016/j.sleep.2019.07.010
ID  - ref1
ER  -