Prenatal depression and sleep: A cross-sectional study in late pregnancy

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Created On: 29/10/2025

Depression frequently affects women during pregnancy, and recognizing modifiable risk factors, such as sleep, is essential.

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Key take away

Better multidimensional sleep health—including quality, duration, and daytime alertness—is associated with a considerably lower risk of depression during late pregnancy.

Background

Depression frequently affects women during pregnancy, and recognizing modifiable risk factors, such as sleep, is essential. While specific aspects of sleep—like insufficient sleep duration and poor sleep quality—have been linked to a heightened risk of depression, the role of overall sleep health as a multidimensional concept remains unclear. Hence, this study sought to explore the connection between multidimensional sleep health and depressive symptoms in the third trimester of pregnancy.

Method

Pregnant women between 28 and 40 weeks of gestation completed self-reported questionnaires assessing 6 dimensions of sleep health: quality, duration, efficiency, timing, regularity, and daytime sleepiness. Each aspect was classified as either "good" or "poor," and a total sleep health score was generated. Depressive symptoms were determined via the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression was utilized to assess links between sleep health components and depression. Using restricted cubic spline analysis, the potential dose-response patterns between depression and overall sleep health was analyzed.

Result

Data from 329 volunteers were analyzed. The average participant age was 31.6 years, with a mean gestational age of 34.7 weeks. Clinically elevated depressive symptoms were noted in 18.2% (n=60) of the participants. A clear dose-response relationship emerged, showing that higher overall sleep health scores were linked with reduced odds of depression (odds ratio [OR] = 0.572). After adjusting for relevant covariates, poor sleep quality (OR = 3.485), short sleep duration (OR = 3.462), and excessive daytime sleepiness (OR = 3.409) were markedly linked to an increased risk of depression.

Conclusion

Depression during late pregnancy appears to be linked not only with specific sleep issues—such as poor quality, insufficient duration, and daytime drowsiness—but also with overall sleep health. Thus, promoting healthy sleep patterns may be a valuable strategy for assisting maternal mental health. Integrating sleep assessments and interventions into routine prenatal care could yield meaningful benefits for emotional well-being during pregnancy.