Browsing by Author "Silang, Katherine"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Sleep and mental health in pregnancy during COVID-19: A parallel process growth model
    (Elsevier, 2022-07-21) Tomfohr-Madsen, Lianne; Rioux, Charlie; MacKinnon, Anna; Silang, Katherine; Roos, Leslie; Lebel, Catherine
    Pregnancy is associated with elevated risk for poor sleep quality, which increases the risk for poor obstetrical outcomes and parent mental health problems. The COVID-19 pandemic has seen increased reports of disturbed sleep worldwide; however, the degree this extends to pregnancy or influences pregnancy mental health outcomes has not been examined. The goal of this study was to examine changes in pregnant individuals’ sleep, anxiety and depression during the pandemic, and to understand how sleep was associated with symptoms of anxiety and depression over time. The Pregnancy During the COVID-19 Pandemic (PdP) study is a prospective longitudinal cohort of pregnant individuals (at enrollment) with repeated follow ups during pregnancy and the postpartum period. 3747 pregnant individuals participated between April and July 2020. The present analysis was restricted to participants who completed at least two assessments, yielding a final sample of 1842 pregnant individuals. Depression symptoms were elevated at baseline, and declined gradually over time, but remained elevated relative to pre pandemic levels. Shorter sleep duration, higher sleep disturbance, and more sleep related impairments at baseline predicted a slower decline in depression symptoms over time. More sleep disturbances at baseline also predicted slower decline in anxiety symptoms over time. In contrast, rates of depression and anxiety symptoms at baseline were not predictive of changes in any of the three sleep variables over time. These findings highlight the importance of early intervention for sleep problems in pregnancy, in order to optimize mental health throughout pregnancy and mitigate long term negative outcomes.
  • Thumbnail Image
    ItemOpen Access
    Sleeping For Two: Evaluating Sleep as a Mediator of the Effect of Cognitive Behavioural Therapy for Insomnia (CBT-I) Delivered in Pregnancy for Postpartum Depression
    (2022-08) Silang, Katherine; Tomfohr-Madsen, Lianne; Campbell, Tavis; Giesbrecht, Gerald
    Background: Insomnia and sleep concerns are common during pregnancy and lead to adverse short- and long-term consequences for the pregnant person and their child. Within the general population, poor sleep, including decreased sleep quality and shortened sleep duration, is associated with worse emotion regulation and low mood; these findings also extend into the perinatal period (Vafapoor et al., 2018; Wang et al., 2018). It is unclear whether improving sleep during pregnancy is associated with better mood, and whether these effects persist into the postpartum period. The primary aim of this study is to investigate whether the treatment of insomnia in pregnancy using cognitive behavioural therapy for insomnia (CBT-I) is associated with improved postpartum depression and whether improvements in sleep (insomnia symptoms) following intervention mediate the relationship between CBT-I treatment and postpartum mood. Methods: A two-arm, single-blinded, parallel groups randomized controlled trial (RCT) design was used to evaluate the impact of a 5-week CBT-I intervention compared to a control group among a sample of 62 pregnant people. Participants were eligible if they were pregnant, between 12-28 weeks’ gestation, and had a diagnosis of insomnia. Participants completed structured interviews to assess depression and sleep in addition to other measures of insomnia (objective and subjective reports), sleep quality and duration. Assessments were completed at 12-28 weeks of pregnancy (T1), six weeks after baseline (T2), and six months postpartum (T3). At the (T3), participants completed a battery of questionnaires measuring psychosocial variables such as mood including depressive symptoms and infant sleep. Results: Using a custom mediation model made in PROCESS V 4.0 and SPSS 26.0, findings from the current study found that there was no direct effect of CBT-I in pregnancy on postpartum depression. However, there was a significant indirect effect of CBT-I on postpartum depression at T3 through a serial mediation from sleep at T2 to sleep at T3 while controlling for baseline symptoms of depression, insomnia, and infant sleep at T3. The indirect effect of CBT-I on depression at T3 through sleep at T2 (single mediation), and the individual indirect effect of CBT-I on depression at T3 through depression at T2 (single mediation) were not significant. Discussion: The current paper aimed to build on the finding that CBT-I in pregnancy reduces postpartum depressive symptoms by trying to understand the mechanism under which CBT-I during pregnancy improves postpartum mood. Findings from this paper suggest that CBT-I leads to sustained improvements in sleep which are associated with lower levels of depression. These results provide further support for the call for increased attention to sleep within the realm of prenatal care and research.