Insomnia, poor sleep quality and perinatal suicidal risk: A systematic review and meta-analysis

J Sleep Res. 2024 Apr;33(2):e14000. doi: 10.1111/jsr.14000. Epub 2023 Jul 13.

Abstract

Suicidal risk in mothers is a public health priority. Risk factors include biological, psychological and psychosocial factors. Among the biological factors, the role of sleep disturbances as potential contributors to increased suicidal risk during the peripartum period is becoming apparent. To explore this further, we conducted a systematic review following the PRISMA criteria. Currently, 10 studies have examined the role of insomnia and poor sleep quality in suicidal risk during the peripartum period and have involved 807,760 women. The data showed that disturbed sleep and poor sleep quality increase the risk of suicidal ideation in both pregnant women with and without perinatal depression. The results of the meta-analysis indicated that insomnia and poor sleep quality increase the odds of suicidal risk in pregnant women by more than threefold (OR = 3.47; 95% CI: 2.63-4.57). Specifically, the odds ratio (OR) for poor sleep quality was 3.72 (95% CI: 2.58-5.34; p < 0.001), and for insomnia symptoms, after taking into account perinatal depression, was 4.76 (95% CI: 1.83-12.34; p < 0.001). These findings emphasise the importance of assessing and addressing sleep disturbances during the peripartum period to mitigate their adverse effects on peripartum psychopathology and suicidal risk.

Keywords: insomnia; peripartum; poor sleep quality; pregnancy; suicidal risk.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Humans
  • Pregnancy
  • Pregnant Women / psychology
  • Sleep Initiation and Maintenance Disorders* / complications
  • Sleep Initiation and Maintenance Disorders* / epidemiology
  • Sleep Quality
  • Sleep Wake Disorders* / complications
  • Sleep Wake Disorders* / epidemiology
  • Sleep Wake Disorders* / psychology
  • Suicidal Ideation