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. 2024 May 1;86(4):272-282.
doi: 10.1097/PSY.0000000000001297. Epub 2024 Mar 4.

Dynamic Associations Among Sleep, Emotion Dysregulation, and Desire to Live in a Perinatal Sample

Parisa R Kaliush  1 , Jonathan E Butner, Paula G Williams, Elisabeth Conradt, Sheila E Crowell
Affiliations

Dynamic Associations Among Sleep, Emotion Dysregulation, and Desire to Live in a Perinatal Sample

Parisa R Kaliush et al. Psychosom Med. .

Abstract

Objective: The present study prospectively examined dynamic associations among sleep, emotion dysregulation, and desire to live during the perinatal transition, as it was theorized that these factors may contribute to the emergence of postpartum suicide risk.

Method: Ninety-four women ( Mage = 29.2 years; 23.4% Latina) wore wrist actigraphs and completed twice daily surveys for 7 days during the third trimester of pregnancy, 6 weeks postpartum, and 4 months postpartum. Multilevel, change-as-outcome models were built to examine changes in attractor dynamics among sleep, emotion dysregulation, and desire to live, as well as if sleep-emotion dysregulation dynamics differed based on participants' desires to live.

Results: From pregnancy to 6 weeks postpartum, emotion dysregulation ( B = -0.09, p = .032) and desire to live ( B = -0.16, p < .001) exhibited more stable temporal patterns around higher emotion dysregulation and lower desire to live. Compared to women who reported consistently high desires to live, those who experienced fluctuations in their desires to live exhibited lower, more stable sleep efficiency during pregnancy ( B = -0.90, p < .001). At 4 months postpartum, those with fluctuating desires to live exhibited a coupling dynamic whereby low sleep efficiency predicted increases in emotion dysregulation ( B = -0.16, p = .020).

Conclusions: This study was the first to examine nonlinear dynamics among risk factors for postpartum suicide, which may be evident as early as pregnancy and 6 weeks postpartum. Sleep health, in particular, warrants further exploration as a key susceptibility factor in the emergence of postpartum suicide risk.

Preregistration: Open Science Framework ( https://osf.io/qxb75/?view_only=799ffe5c048842dfb89d3ddfebaa420d ).

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Conflict of interest statement

Conflicts of Interest and Source of Funding

The authors declare no conflicts of interest. This work was supported by the National Institute of Mental Health (NIMH) under awards R01MH119070 (MPIs Crowell & Conradt) and F31MH124275 (PI Kaliush); the Utah Center for Clinical and Translational Science under award UL1TR002538 (MPIs Crowell & Conradt); the American Psychological Foundation (APF); the American Psychological Association (APA) Division of Health Psychology; and the Society for Research on Child Development (SRCD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH, APF, APA, or SRCD.

Figures

Figure 1:
Figure 1:
Interaction Between Sleep Efficiency and Desire to Live Predicting Change in Emotion Dysregulation During 4 months Postpartum Note. This plot depicts the significant interaction during 4 months postpartum (i.e., wave 3) between sleep efficiency and desire to live (0 = no variability in desire to live over time, 1 = variability in desire to live over time) on change in emotion dysregulation. Among those who experienced fluctuations (i.e., variability) in their desires to live, high sleep efficiency predicted decreases in emotion dysregulation, and low sleep efficiency predicted increases in emotion dysregulation. Among those who experienced consistently high desires to live over time (i.e., no variability), sleep efficiency did not predict changes in emotion dysregulation.
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