Digital cognitive behavioral therapy for insomnia (dCBT-I) during pregnancy may prevent postpartum depression and reduce insomnia and anxiety up to 6 months postpartum, according to study findings published in the journal Sleep.

The study was a follow-up to a previous investigation that found the dCBT intervention reduced insomnia, depression, and anxiety in women during pregnancy.

“We were curious to see whether the benefits of dCBT-I would maintain after the birth of the child, especially given the demands of having a young infant,” said study leader Jennifer Felder, PhD, assistant professor of psychiatry and core research faculty at the Osher Center at University of California—San Francisco. “We were particularly excited to see the benefits lasted to 6 months not just for insomnia, but for mental health more broadly.”

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Researchers randomized pregnant women with insomnia to 6 weekly sessions of dCBT-I or to standard care. The 105 women assigned to dCBT-I used a self-paced sleep app (Sleepio) 20 minutes at a time, up to 6 times. Standard care included general sleep hygiene tips from clinicians or medication.

Women assigned dCBT-I had higher rates of insomnia remission at 6 months postpartum, as well as greater improvements in anxiety symptom severity between baseline and 3 months postpartum, according to the study. They also showed greater improvements in depressive symptom severity at both 3 and 6 months.

Just 4% of women in the dCBT-I group had probable major depression 3 months after giving birth, researchers reported, compared with 18% of women who received standard care. In the subset of women with minimal depressive symptoms at baseline, 0% who received dCBT-I had probable major depression at 3 months, compared with 18% of women who received standard care.

“I’ve heard patients say, over and over, that their postpartum mental health began to suffer when their insomnia started, suggesting there is a link,” said Dr Felder. “We know that postpartum can be a vulnerable time for becoming depressed, and it is possible that this intervention may prevent that.”

References

Felder JN, Epel ES, Neuhaus J, Krystal AD, Prather AA. Randomized controlled trial of digital cognitive behavior therapy for prenatal insomnia symptoms: effects on postpartum insomnia and mental health. Sleep. Published online November 27, 2021. doi: 10.1093/sleep/zsab280

Digital therapy for prenatal insomnia may prevent postpartum depression. News release. University of California - San Francisco. December 15, 2021. Accessed January 13, 2022.