Mindfulness and nocturnal rumination are independently associated with symptoms of insomnia and depression during pregnancy.
David A Kalmbach, Thomas Roth, P. Cheng, J. Ong, Elana Rosenbaum, C. Drake
Sleep Health March 4, 2020 DOI: 10.1016/j.sleh.2019.11.011 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 65 |
| Population | Pregnant women recruited from a multisite hospital in Metro Detroit, MI, USA |
| Topics | Depression Meditation |
| Key findings | Both lower mindfulness and higher nocturnal rumination were independently associated with greater insomnia and depression during pregnancy. |
Abstract
Background: Insomnia and depression are highly prevalent perinatal complications. Ruminating on stress is etiologically implicated in both disorders, and ruminating while trying to fall asleep has been linked to insomnia and depression during pregnancy. Incompatible with rumination is everyday mindfulness, i.e., living with intentional and nonjudgmental awareness of internal and external experiences in the present moment. Responding to stress mindfully may protect against stress-related perinatal complications such as insomnia and depression. The present study described the association between everyday mindfulness and nocturnal rumination, and examined whether these trait characteristics were independently related to perinatal insomnia and depression.
Methods: Cross-sectional and secondary analysis of existing data from 65 pregnant women recruited from a multisite hospital in Metro Detroit, MI, USA. Subjects completed online surveys including the Insomnia Severity Index, Edinburgh Postnatal Depression Scale, Presleep Arousal Scale, and the revised Cognitive and Affective Mindfulness Scale.
Results: Over half (53.8%) of women screened positive for clinical insomnia and 12.3% screened positive for major depression. Women high in mindfulness, relative to those low in mindfulness, reported less nocturnal rumination (Cohen's d=1.16), insomnia symptoms (Cohen's d=1.24), and depressive symptoms (Cohen's d=1.35). Multivariate linear regression revealed that both mindfulness (β=-.24, p=.03) and rumination (β=.38, p<.01) were independently associated with insomnia. Similarly, a multivariate model showed that mindfulness (β=-.41, p<.001) and rumination (β=.35, p<.01) were independently associated with depression.
Conclusions: Ruminating in bed at night is strongly associated with insomnia and depression during pregnancy, whereas mindfulness may potentially protect against these stress-related perinatal complications.
Comparable studies
Other cross-sectional and survey studies on depression, most cited first.
Citations in the library
Cited by 10
- Reducing cognitive arousal and sleep effort alleviates insomnia and depression in pregnant women with DSM-5 insomnia disorder treated with a mindfulness sleep program. SLEEP Advances 2023
- Perinatal Understanding of Mindful Awareness for Sleep (PUMAS): A single-arm proof-of-concept clinical trial of a mindfulness-based intervention for DSM-5 insomnia disorder during pregnancy. Sleep Medicine August 1, 2023
- Preliminary evidence of psychological improvements and increased maternal-fetal attachment associated with a mindfulness sleep programme: secondary analysis of uncontrolled data in 11 pregnant women with insomnia disorder. Journal of Sleep Research February 1, 2024
- Effectiveness and Mechanisms of a Digital Mindfulness-Based Intervention for Subthreshold to Clinical Insomnia Symptoms in Pregnant Women: Randomized Controlled Trial. Journal of Medical Internet Research May 5, 2025
- Bidirectional relationships between mindfulness and symptoms of depression and anxiety during pregnancy and postpartum. Journal of reproductive and infant psychology May 7, 2025
and 5 more in the library
Cites 9
- Mindfulness-based cognitive therapy for depression August 21, 2006
- A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia Sleep August 29, 2014
- Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis Mindfulness December 1, 2017
- How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review April 1, 2015
- CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Archives of women's mental health January 22, 2014
and 4 more in the library