ABSTRACT

Objective

Emerging evidence links maternal and infant sleep problems to impairments in the mother-to-infant bond, but the independence and directionality of these associations remain unclear. The present study characterized concurrent and prospective effects of maternal sleep disturbances and poor infant sleep on the mother-infant relationship. As common sequalae of problematic sleep, nocturnal cognitive hyperarousal and daytime sleepiness were investigated as facilitating mechanisms.

Participants

Sixty-seven pregnant women enrolled in a prospective study on maternal sleep.

Methods

Sociodemographic information and clinical symptoms were measured prenatally then weekly across the first two postpartum months. Women reported insomnia symptoms, sleep duration, snoring, daytime sleepiness, nocturnal cognitive arousal (broadly focused and perinatal-specific), perseverative thinking, depression, infant colic, infant sleep quality, and mother-infant relationship quality. Mixed effects models were conducted to test hypotheses.

Results

Prenatal snoring and weak maternal-fetal attachment augured poorer postpartum bonding. Poor infant sleep was associated with increased odds for maternal insomnia and short sleep. Impairments in the mother-to-infant bond were linked to maternal insomnia, nocturnal perinatal-focused rumination, daytime sleepiness, depression, and poor infant sleep. Postnatal insomnia predicted future decreases in mother-infant relationship quality, and nocturnal cognitive hyperarousal partially mediated this association.

Conclusions

Both maternal and infant sleep problems were associated with poorer mother-to-infant bonding, independent of the effects of maternal depression and infant colic. Perseverative thinking at night, particularly on infant-related concerns, was linked to impaired bonding, rejection and anger, and infant-focused anxiety. Improving maternal and infant sleep, and reducing maternal cognitive arousal, may improve the maternal-to-infant bond.

中文翻译：

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母婴关系与母亲失眠、打鼾、认知唤醒、婴儿睡眠问题和绞痛有关

摘要

客观的

新的证据表明，母婴睡眠问题与母婴关系受损有关，但这些关联的独立性和方向性仍不清楚。本研究描述了母亲睡眠障碍和婴儿睡眠不良对母婴关系的同时和前瞻性影响。作为睡眠问题的常见后遗症，夜间认知过度觉醒和白天嗜睡被作为促进机制进行了研究。

参加者

六十七名孕妇参加了一项关于母亲睡眠的前瞻性研究。

方法

社会人口统计信息和临床症状在产前进行测量，然后在产后前两个月每周进行一次测量。女性报告了失眠症状、睡眠持续时间、打鼾、白天嗜睡、夜间认知唤醒（广泛关注和围产期特定）、持续思考、抑郁、婴儿绞痛、婴儿睡眠质量和母婴关系质量。采用混合效应模型来检验假设。

结果

产前打鼾和母婴依恋薄弱预示着产后关系较差。婴儿睡眠不佳与母亲失眠和睡眠不足的几率增加有关。母婴关系受损与母亲失眠、围产期夜间沉思、白天嗜睡、抑郁和婴儿睡眠不佳有关。产后失眠预示着未来母婴关系质量的下降，而夜间认知过度唤醒部分介导了这种关联。

结论

母亲和婴儿的睡眠问题都与母婴关系较差有关，与母亲抑郁和婴儿绞痛的影响无关。夜间持续思考，尤其是与婴儿相关的问题，与亲密关系受损、拒绝和愤怒以及以婴儿为中心的焦虑有关。改善母亲和婴儿的睡眠，减少母亲的认知唤醒，可能会改善母婴关系。