Sleep Quality Predicts Persistence of Parental Postpartum Depressive Symptoms and Transmission of Depressive Symptoms from Mothers to Fathers

Ann Behav Med. 2016 Dec;50(6):862-875. doi: 10.1007/s12160-016-9815-7.


Background: Early parenthood is a time of chronic sleep disturbance and also of heightened depression risk. Poor sleep quality has been identified both as a predictor of postpartum depressive symptoms and as a consequence.

Purpose: This study sought to clarify causal pathways linking sleep and postpartum depression via longitudinal path modeling. Sleep quality at 6 months postpartum was hypothesized to exacerbate depressive symptoms from 1 month through 1 year postpartum in both mothers and fathers. Within-couple associations between sleep and depression were also tested.

Methods: Data were drawn from a low-income, racially and ethnically diverse sample of 711 couples recruited after the birth of a child. Depressive symptoms were assessed at 1, 6, and 12 months postpartum, and sleep was assessed at 6 months postpartum.

Results: For both partnered mothers and fathers and for single mothers, depressive symptoms at 1 month postpartum predicted sleep quality at 6 months, which in turn predicted depressive symptoms at both 6 and 12 months. Results held when infant birth weight, breastfeeding status, and parents' race/ethnicity, poverty, education, and immigration status were controlled. Mothers' and fathers' sleep quality and depressive symptoms were correlated, and maternal sleep quality predicted paternal depressive symptoms both at 6 and at 12 months.

Conclusions: Postpartum sleep difficulties may contribute to a vicious cycle between sleep and the persistence of depression after the birth of a child. Sleep problems may also contribute to the transmission of depression within a couple. Psychoeducation and behavioral treatments to improve sleep may benefit new parents.

Keywords: Couples; Parents; Postpartum depression; Sleep; Sleep disturbance; Sleep duration.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Breast Feeding / psychology
  • Depression / complications
  • Depression / diagnosis*
  • Depression / psychology
  • Depression, Postpartum / complications
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parents / psychology*
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Sleep / physiology*
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / psychology
  • Young Adult