Perinatal anxiety and sleep : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Albany, New Zealand

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Introduction. Anxiety symptoms and sleep health issues are common during the perinatal period. Few studies have investigated differences in prevalence of these issues for Māori and non-Māori women and considered the relationships between anxiety and sleep across this timeframe. Objective. This study investigated the prevalence of anxiety symptoms in a large community sample of Māori and non-Māori women, and the cross-sectional and longitudinal relationships between anxiety and sleep from late pregnancy through to 3 months postpartum. Methods. The longitudinal Moe Kura cohort study collected self-report data from 1144 women (406 Māori and 738 non-Māori) at several time points (prior to pregnancy, late pregnancy, 4-6 weeks postpartum and 12 weeks postpartum). Pearson’s chi-square tests and univariate analyses were calculated to understand the sample and binary logistic regression models were used to investigate cross-sectional and longitudinal relationships. Results. Results indicated bi-directional relationships between anxiety and sleep health at several time points across the perinatal period. Women with long sleep latencies were more than twice as likely to experience high anxiety symptoms (OR=2.11 at T2 and 2.71 at T4) and vice versa (OR=2.11 at T2 and 2.66 at T4). In late pregnancy, short sleep, daytime sleepiness and leg twitching/jerking, had a bi-directional relationship with high anxiety symptoms but this was not seen at other time points. Longitudinal analyses showed that high anxiety symptoms in late pregnancy were predictive of high anxiety symptoms postpartum. Conclusion. The bi-directional nature of the relationship between long sleep latency and high anxiety symptoms could be used to develop questions to ask women so these issues can be identified and followed up. This is critical, as the most consistent predictor of high anxiety symptoms postpartum was high anxiety symptoms in late pregnancy. This study also highlights the high prevalence of anxiety and sleep health issues in pregnancy and the importance of ensuring identification, treatment and support of women across the perinatal period. The Kaupapa Māori principles incorporated in the design and implementation of the Moe Kura cohort study enables valuable insights into the experiences of Māori and non-Māori women and the differences between them.
anxiety, sleep, sleep health, EPDS anxiety subscale, perinatal mental health, maternal mental health, Māori Masters Thesis