As soon as I saw the title of the conference slated for June 6th, “Sleep Matters: Effects on Maternal Mental Health & Infant Behavior,” I told myself I had to register for it. And register for it I did. The important of sleep–and the lack thereof during the first postpartum weeks–is a topic that is near and dear to my heart. After all, insomnia was my first symptom that something wasn’t right. That I was about to embark on a frightening postpartum depression (PPD) journey.
Dr. James Maas, one of the leading sleep experts, the author of Sleep for Success and the consultant to many a professional athlete/athletic team, was the first to speak. And boy, was he one dynamic speaker…one of the best I’ve ever had the privilege of listening to! He starts off confirming what we have probably all heard countless times before….that our society is comprised of sleep deprived individuals who don’t get the 8 hours of sleep a night recommended by the sleep experts; that those who sleep less than 6-7 hours a night are more prone to getting sick and have higher blood pressure due to higher cortisol levels. Remind me to sleep more during the winter when the shorter days and resulting Vitamin D deficiency–not to mention, the greater number of people being sick, period–cause me to get sick on average once every other month. The one main thing I took away from Dr. Maas presentation–other than the fact that I learned that Sara Hughes, 2002 ice skating gold medalist, attributes her gold medal win to his sleep advice–that as little as 15 LUX of blue light, like light emanating from smart phones, the iPad, e-readers, computers, and television, suppresses melatonin, the hormone that is critical to the regulation of your sleep-wake cycle.
Then there was Leslie Swanson, PhD and Roseanne Armitage, PhD, both from the University of Michigan. A lot of the great information these subject matter experts covered in their separate presentations I already knew from the books and articles I’d read over the past years. But what these presentations had in common with Dr. Maas’ presentation–which I wish I could’ve known BEFORE I had my daughter–was the importance of avoiding exposure to blue light within an hour of going to sleep, as blue light suppresses melatonin secretion (a hormone that induces sleep). Exposure to blue light is best from the time you wake up in the AM and for the time you need to be up. I had my daughter in December, which meant I had to spend my first postpartum weeks being exposed to the least amount of light of the year, with a 1/3 ratio of daylight (8 hours) to darkness (16 hours). Yes, indeed, two reasons to hate winter: cold and short days. But I’m not sure a knowledge of blue versus red lights and how to use that information to help improve sleep would’ve helped me back when INSOMNIA hit me from left field when I didn’t even know what PPD was to begin with.
What’s a conference on perinatal mood disorders without the esteemed Kathleen Kendall-Tackett, IBCLC, a health psychologist, board-certified lactation consultant, La Leche League Leader?! I’ve had the privilege of hearing her at practically every Postpartum Support International conference I’ve been to. Like the previous presenters, Kathleen talked about bright light therapy. She wrote this Bright Light Therapy for Depression article for the Texas Tech University Health Sciences Center, for which she is clinical associate professor of pediatrics. Among all the data she shared with us was the result of a study that showed that depression tended to occur at 3 months among mothers who had less than 4 hours of uninterrupted sleep.
What I also wish I had known BEFORE I had my daughter is that:
- sleep and depression are intimately connected,
- sleep deprivation is a risk factor for PPD, and
- getting 4-5 hours of uninterrupted sleep is critical especially to the new mother at high risk (in my case I was high risk due to the events leading up to the 6th week postpartum, especially when it comes to my childbirth complications, my being starved for 7 days, and inability to get uninterrupted sleep even from day one at the hospital because the staff was constantly waking me up through the night).
It’s reasonable to believe that sleep deprivation in a society of super-achieving mothers–mothers who feel they should be able to do it all (take care of baby, cook, keep up the house and round-the-clock breastfeeding) with very little to no help and inadequate amounts of sleep–has caused PPD to crop up in 1 out of 8 new moms! This also applies to moms with no family nearby to help with the baby, as I previously wrote about in my post on the historical perspective on social support.
I can tell you from my experience that, and I’m confident many other moms feel the same, before my daughter was able to sleep through the night, when she was waking every 2-3 hours or in highly irregular intervals (she was not a great sleeper in the beginning until we determined she had to sleep upright for the first month or so, so we kept her in her car seat, and she had to sleep tightly swaddled–both of these things we had to learn through trial and error as I had mentioned in prior posts), my apprehension that at any minute, I would have to be checking on the baby and/or feeding her prevented me from feeling truly at ease and able to fall asleep as easily as my husband did each and every night for the first few weeks. Had there been guilt-free care (i.e., no need to worry about my husband getting enough sleep because he had to work the next day) and an assurance that there was someone there to do the night time feedings each and every night until she could sleep through the night, I could’ve very well have prevented my PPD onset entirely. That would only have been possible, however, if we had known enough to hire a doula ahead of time to spend the evenings with us for the first couple of months.
Speaking of apprehension, I had mentioned in my book how fatigue, depression and stress are highly interrelated in that sleep deprivation can trigger the stress response, which results in the production of stress hormone (i.e., cortisol). Cortisol, in turn, causes a decrease in the level of the neurotransmitter serotonin. A decrease in serotonin usually leads to insomnia.
I’d like to wrap up this post with a little yelp of excitement in that Kathleen Kendall-Tackett bought a copy of my book! This woman has written more than 300 articles, authored/edited 22 books, was a founding editor for two scholarly journals, and served on the editorial boards of five others. First Jeanne Watson-Driscoll, and now Kathleen Kendall-Tackett. I wonder who’s next?