Association of Fewer Hours of Sleep at 6 Months Postpartum with Substantial Weight Retention at 1 Year Postpartum

Division of Research, Kaiser Permanente Research Foundation, Oakland, CA 94612, USA.
American journal of epidemiology (Impact Factor: 5.23). 01/2008; 167(2):178-87. DOI: 10.1093/aje/kwm298
Source: PubMed


Shorter sleep duration is linked to obesity, coronary artery disease, and diabetes. Whether sleep deprivation during the postpartum
period affects maternal postpartum weight retention remains unknown. This study examined the association of sleep at 6 months
postpartum with substantial postpartum weight retention (SPPWR), defined as 5 kg or more above pregravid weight at 1 year
postpartum. The authors selected 940 participants in Project Viva who enrolled during early pregnancy from 1999 to 2002. Logistic
regression models estimated odds ratios of SPPWR for sleep categories, controlling for sociodemographic, prenatal, and behavioral
attributes. Of the 940 women, 124 (13%) developed SPPWR. Sleep distributions were as follows: 114 (12%) women slept ≤5 hours/day,
280 (30%) slept 6 hours/day, 321 (34%) slept 7 hours/day, and 225 (24%) slept ≥8 hours/day. Adjusted odds ratios of SPPWR
were 3.13 (95% confidence interval (CI): 1.42, 6.94) for ≤5 hours/day, 0.99 (95% CI: 0.50, 1.97) for 6 hours/day, and 0.94
(95% CI: 0.50, 1.78) for ≥8 hours/day versus 7 hours/day (p = 0.012). The adjusted odds ratio for SPPWR of 2.05 (95% CI: 1.11, 3.78) was twofold greater (p = 0.02) for a decrease in versus no change in sleep at 1 year postpartum. Sleeping ≤5 hours/day at 6 months postpartum was
strongly associated with retaining ≥5 kg at 1 year postpartum. Interventions to prevent postpartum obesity should consider
strategies to attain optimal maternal sleep duration.

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Available from: Erica P Gunderson
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    • "The disturbance of sleep cycle during postpartum period might last for several weeks or months. If it persists or worsens, it may negatively affect breastfeeding and reduce mother-infant bonding (Gunderson et al., 2008). Consequently , poor sleep quality, stress, mood sway, and depression may also occur in the mothers and their family members (Posmontier, 2008; Dennis and Ross, 2005). "
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    ABSTRACT: Prolonged poor sleeping quality can decrease women's ability to perform their maternal and family duties after delivery. The aim of this study was to investigate the effects of a Pilates training program on sleep quality in primigravida postpartum women in a randomized clinical trial. Eighty postpartum women were randomly divided into intervention and control groups (n = 40). Home-based 30-min Pilate's exercises were started 72 h after the delivery and performed five times per week for consecutive 8 weeks. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) prior to the intervention and 4th and 8th weeks afterwards. The intervention group showed a significant improvement in subjective sleep quality, sleep latency, daytime dysfunction and global PSQI score (P < 0.001); however, there was no difference in sleep duration, habitual sleep efficiency and sleep disturbance between the groups. In conclusion, Pilates exercises appeared to improve sleep quality in primigravida postpartum women.
    Full-text · Article · Apr 2014 · Journal of bodywork and movement therapies
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    • "Thus, BED may be linked to weightpromoting behaviors during pregnancy. Reduced sleep duration, which has been linked to obesity [31] [32] [33] [34] and weight retention in the postpartum period [35] also may influence weight gain during pregnancy. Additionally, poor sleep quality early in pregnancy has been linked to increased depressed mood later in pregnancy [36] [37], and poor sleep quality in late pregnancy has been predictive of early postpartum depression [38]. "
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    ABSTRACT: Objectives. To describe psychosocial factors identified as contributors of weight gain in the general population and to examine the relationship between these factors and gestational weight gain among low socioeconomic status, African American, overweight pregnant women. Methods. African American women (n = 120) with a pregravid body mass index ≥25 kg/m(2) completed measures of eating, sleep, and depressed mood between 14 and 24 weeks of gestation. Weight was tracked. Descriptive statistics, correlations, and linear regression modeling were used to characterize the sample and examine predictors of gestational weight gain. Results. Four percent screened positive for night eating syndrome, with 32% consuming at least 25% of their daily caloric intake after dinner (evening hyperphagia). None met criteria for binge eating disorder; 4% reported occasional binge episodes. Cognitive restraint over eating was low. Participants slept 7.1 (SD = 1.9) h per night and reported 4.3 (SD = 3.6) awakenings per week; 18% reported some level of depressed mood. Night and binge eating were related to each other, sleep quality, and depressed mood. Eating due to cravings was the only psychosocial variable to predict gestational weight gain. Conclusions. Depressed mood, night eating, and nighttime awakenings were common in this cohort, while cognitive restraint over eating was low. Most psychosocial variables were not predictive of excess gestational weight gain.
    Full-text · Article · Nov 2012 · Obstetrics and Gynecology International
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    • "Oken and colleagues concluded that hours of television viewing and trans fat intake increased the risk of substantial weight retention, whereas walking was a significant preventative factor [15]. Gunderson concluded that women sleeping ≤5 hours per day at six months postpartum had a threefold higher risk of substantial weight retention at one year postpartum [16]. "
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    ABSTRACT: Postpartum weight retention affects many women and increases the risk of becoming overweight. The research objective was to study modifiable factors contributing to weight change at one year postpartum. In this prospective cohort, postpartum behavior, such as physical activity, sedentary behavior, sleep, and intake of total energy, total fat and saturated fatty acids of 118 Dutch women were assessed in 2003/2004 by self-report at 6 weeks, 6 and 12 months postpartum. Mean postpartum scores were computed for the behavioral measures. In linear regression models it was determined which factors were associated with average weight change from before pregnancy to one year postpartum. Furthermore, factors associated with substantial postpartum weight retention (≥ 5 kg) were also studied in logistic regression models. At one year postpartum, the average weight of participants had increased by 0.9 kg (SD 4.4). Moreover, 20% of the women retained ≥ 5 kg. Women who perceived themselves more physically active than others were almost ten times less likely to retain ≥ 5 kg than women who perceived themselves equally active (OR = 0.11, 95%CI: 0.02 - 0.66). Exceeding the guideline for saturated fatty acid intake (OR = 3.40, 95%CI: 1.04 - 11.11), total gestational weight gain (OR = 1.14/kg, 95%CI: 1.01 - 1.27), and not having completed post high school education (OR = 5.13, 95%CI: 1.66 - 15.90) increased the odds of retaining ≥ 5 kg. Since one in five women had substantial weight retention postpartum, effective interventions for the prevention of weight retention are much needed. Future studies should evaluate whether interventions focusing on the identified modifiable postpartum factors are successful in reducing weight retention after childbirth.
    Full-text · Article · Mar 2011 · BMC Public Health
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