Preventing postpartum insomnia by targeting maternal versus infant sleep: a protocol for a randomized controlled trial (the Study for Mother-Infant Sleep "SMILE").
Preventing postpartum insomnia by targeting maternal versus infant sleep: a protocol for a randomized controlled trial (the Study for Mother-Infant Sleep "SMILE").
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DOI：
10.1093/sleepadvances/zpab020
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Bei B
中科院分区：
文献类型：
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作者：
Quin N;Tikotzky L;Stafford L;Fisher J;Bei B
失眠症状在围产期很常见，并且与父母/婴儿的不良结局有关。关于失眠发展的理论（例如 3P 模型）表明，严重的睡眠中断（例如夜间婴儿护理）可能会导致失眠，而与睡眠相关的无益认知/行为可能会使父母的失眠症状持续下去。本研究旨在探讨两种干预措施（一种将婴儿睡眠作为诱因，另一种将母亲与睡眠相关的认知/行为作为持久因素）如何预防产后失眠。参与者为 114 名妊娠 26 至 32 周的未生育女性，她们自我报告有失眠症状（失眠严重指数评分≥8）。参与者被随机分配到三种情况之一，并接受：(1) 产后 6 个月之前使用的“响应式摇篮”，旨在促进/巩固婴儿睡眠，并将婴儿睡眠作为失眠的诱因，(2) 治疗师辅助的失眠认知行为疗法，解决作为失眠持续因素的无益的睡眠相关认知/行为，或 (3) 睡眠卫生手册（控制条件）。主要结局是产妇失眠症状。次要结局包括产妇睡眠持续时间/质量、心理健康（例如抑郁、焦虑）和幸福相关变量（例如睡眠相关障碍）。使用经过验证的仪器在妊娠 26-32 周和 35-36 周以及产后 2、6 和 12 个月时评估结果。本研究采用早期干预方法，纵向比较两种不同的预防高危人群产后失眠的方法。如果干预措施有效，研究结果将证明针对不同机制的干预措施如何减轻围产期人群的失眠症状。这将为未来开发多成分睡眠干预以改善母婴健康提供经验证据。 临床试验注册：母婴睡眠研究（SMILE 项目）：通过婴儿睡眠干预和初为人母的母亲睡眠干预来减少产后失眠。 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377927，澳大利亚新西兰临床试验注册中心：ACTRN12619001166167。
Symptoms of insomnia are common during the perinatal periods and are linked to adverse parent/infant outcomes. Theories on insomnia development (e.g. 3P model) suggest that significant sleep disruption (e.g. nighttime infant care) can precipitate, while unhelpful sleep-related cognitions/behaviors can perpetuate parental insomnia symptoms. This study aims to examine how two interventions, one addressing infant sleep as the precipitator, the other targeting maternal sleep-related cognitions/behaviors as the perpetuator, might prevent postpartum insomnia. Participants are 114 nulliparous females 26 to 32 weeks gestation, with self-reported insomnia symptoms (Insomnia Severity Index scores ≥ 8). Participants are randomized to one of three conditions and receive: (1) a “responsive bassinet” used until 6 months postpartum, designed to boost/consolidate infant sleep and target infant sleep as a precipitator of insomnia, (2) therapist-assisted cognitive behavioral therapy for insomnia, addressing unhelpful sleep-related cognitions/behaviors as perpetuators of insomnia, or (3) a sleep hygiene booklet (control condition). The primary outcome is maternal insomnia symptoms. Secondary outcomes include maternal sleep duration/quality, mental health (e.g. depression, anxiety), and wellbeing-related variables (e.g. sleep-related impairment). Outcomes are assessed using validated instruments at 26–32 and 35–36 weeks’ gestation, and 2, 6, and 12 months postpartum. This study adopts an early-intervention approach and longitudinally compares two distinct approaches to prevent postpartum insomnia in an at-risk population. If interventions are efficacious, findings will demonstrate how interventions targeting different mechanisms mitigate insomnia symptoms in perinatal populations. This will provide empirical evidence for future development of multi-component sleep intervention to improve mother-infant wellbeing. Clinical Trial Registration: The Study for Mother-Infant Sleep (The SMILE Project): reducing postpartum insomnia using an infant sleep intervention and a maternal sleep intervention in first-time mothers. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377927, Australian New Zealand Clinical Trials Registry: ACTRN12619001166167.