0564 Trait Mindfulness Protects Against the Harmful Effects of Nocturnal Cognitive Arousal on Insomnia and Depression Symptoms in Pregnancy and Postpartum
Mika Hirata, Heba A Afaneh, Ishana Kapoor, David A Kalmbach, Anthony N Reffi, Matthew B Jennings, P. Cheng, J. Ong, C. Drake
Sleep May 1, 2025 DOI: 10.1093/sleep/zsaf090.0564 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective longitudinal observational study Peer reviewed |
|---|---|
| Sample size | 9 |
| Population | Perinatal women in late pregnancy and early postpartum (mean age 29.9 years; mean gestation at enrollment 26.7 weeks) |
| Duration | Weekly surveys for 4 months across late pregnancy and early postpartum |
| Measures | Revised Cognitive and Affective Mindfulness Scale (CAMS-R), Pre-Sleep Arousal Scale cognitive factor (PSASC), Insomnia Severity Index (ISI), Edinburgh Postnatal Depression Scale (EPDS) |
| Topics | Depression Meditation |
| Key findings | Women with high trait mindfulness reported lower insomnia and depression symptoms across four months, and mindfulness moderated the effect of nocturnal cognitive arousal on future symptoms. Risk was lowest with high mindfulness and low arousal (3.9% insomnia, 9.8% depression) and highest with low mindfulness and high arousal (62.2% insomnia, 83.8% depression). |
Abstract
Perinatal women are highly vulnerable to insomnia and depression. High cognitive arousal (e.g., worry, rumination) at night is a key risk factor for developing insomnia and depression during this period. However, mindfulness skills have been proposed to reduce risk for negative health outcomes by protecting individuals against the harmful effects of cognitive arousal. This prospective study tested whether trait mindfulness protects perinatal women against the harmful effects nocturnal cognitive arousal on insomnia and depression. Nine women (Age: 29.9±4.4y; Gestation at enrollment: 26.7±1.0w) completed weekly health surveys for 4 months across late pregnancy and early postpartum. Study outcomes included the revised cognitive and affective mindfulness scale (CAMS-R), pre-sleep arousal scale’s cognitive factor (PSASC), insomnia severity index (ISI), and Edinburgh postnatal depression scale (EPDS). Linear mixed modeling was used to account for repeated measures and to test trait effects (between-person differences) and state effects (within-person changes) while controlling for relevant covariates. Lagged linear mixed modeling showed that women with high trait mindfulness reported lower levels of ISI (b=-5.37, p=.032) and EPDS (b=-14.25, p<.001) across the next four months. However, within-person analyses showed higher state PSASC predicted higher levels of next-week ISI (b=1.95, p.030) and EPDS (b=1.28, p=.047). Mixed modeling also revealed significant moderation effects for CAMS-R*PSASC on future ISI (b=.01, p<.001) and EPDS (b=.002, p=.012) such that the magnitude of PSASC’s effects on ISI and EPDS were smaller for women with high trait mindfulness. Indeed, insomnia- and depression-risk were lowest when women endorsed high CAMS-R and low PSASC (3.9% insomnia, 9.8% depression), whereas disease-risk was highest when women endorsed low CAMS-R and high PSASC (62.2% insomnia, 83.8% depression). Perinatal women with high trait mindfulness are protected against the harmful effects of high cognitive arousal on insomnia and depression, whereas women with low mindfulness are at higher risk for insomnia and depression when experiencing high cognitive arousal. These prospective data support trait mindfulness as a critical protective factor against the development of insomnia and depression during pregnancy and postpartum. Interventions promoting mindfulness skills may help expecting moms sleep and feel better. Funding: American Academy of Sleep Medicine (198-FP-18, PI: Kalmbach).