The influence of sleep quality on weight retention in the postpartum period

Appl Physiol Nutr Metab. 2021 Jan;46(1):77-85. doi: 10.1139/apnm-2019-0896. Epub 2020 Jul 22.


Poor sleep in the postpartum is often treated as an unavoidable consequence of childbirth. This study aims to compare objective and subjective measures of sleep, explore the relationship between sleep and postpartum weight retention (PPWR), and investigate factors that may contribute to sleep quality in the postpartum period. In this cross-sectional cohort, PPWR, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), and objective sleep and physical activity (accelerometry) were assessed in 109 women 0-52 weeks postpartum. Anthropometric and demographic data were collected. Gestational weight gain (GWG) was classified as inadequate, appropriate, or excessive according to Institute of Medicine guidelines. Average GWG (33.7 lbs) and PPWR (5.39 lbs) were not different between "good" (PSQI < 6) and "bad" (PSQI ≥ 6) sleepers. Following adjustment, mothers with excessive GWG who were "bad" sleepers had 5.26 higher odds of PPWR ≥ 10 lbs compared with all other combinations of GWG and PSQI. PSQI was not correlated with total sleep time (accelerometer-derived). Light activity and moderate-to-vigorous physical activity (MVPA) were associated with reduced odds of being a "bad" sleeper. The influence of GWG on PPWR was modified by postpartum sleep quality. Both light activity and meeting the MVPA guidelines in the postpartum were associated with higher sleep quality. Novelty Subjectively rated poor sleep may represent the number of awakenings and wake after sleep onset in postpartum women. Poor postpartum sleep quality increases excessive postpartum weight retention in women with excessive GWG. Women doing light-to-vigorous physical activity in the postpartum are less likely to experience poor sleep quality.

Keywords: PSQI; activité physique; physical activity; post-partum; postpartum; postpartum weight retention; qualité du sommeil; rétention de poids post-partum; sleep quality.

MeSH terms

  • Accelerometry
  • Adult
  • Body Weight / physiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Female
  • Humans
  • Overweight / complications*
  • Overweight / physiopathology*
  • Postpartum Period / physiology
  • Puerperal Disorders / physiopathology*
  • Sleep / physiology
  • Sleep Wake Disorders / complications*
  • Sleep Wake Disorders / physiopathology*