Association Between Maternal Sleep Health and Mental Health: Moderating Role of Family Function

Objective: Pregnancy, as a complex physiological process, significantly alters maternal sleep patterns, which are closely associated with various maternal health outcomes. This study explored the association between maternal sleep health and anxiety/depression symptoms and whether this association differed by family function. Methods: A cross-sectional survey was conducted among pregnant women attending obstetrics departments at two hospitals in Nanjing, China. The Sleep Health Index, Family APGAR, and Patient Health Questionnaire-4 were administered to evaluate sleep health, family function, and anxiety and depression symptoms of pregnant women in late pregnancy, respectively. Multiple linear and logistic regressions were applied, with the moderation effect of the family function being assessed by adding interaction terms in the models. Results: A total of 199 pregnant women in late pregnancy completed the survey. The average age and gestational age were 30.95 years (SD = 3.38, Range: 19-42) and 36.39 weeks (SD = 2.52, Range: 28-40), respectively. The scores of sleep health, anxiety, depression, and family function were 84.37 +/- 10.61, 0.00 (0.00, 2.00), 0.00 (0.00, 1.00), and 8.79 +/- 1.82, respectively. Results showed that better sleep health was associated with lower scores of anxiety (beta=-0.03, p < .001) and depression (beta=-0.04, p < .001) symptoms and lower odds of anxiety (adjusted odds ratio, aOR = 0.92, p = .006) and depression (aOR = 0.93, p = .003) symptoms. Family function significantly moderated the relationship between sleep health and scores of anxiety (beta = 0.01, p = .013) and depression (beta = 0.01, p < .001) symptoms. Conclusion: Good sleep health in late pregnancy is associated with reduced anxiety and depression symptoms, with a stronger association found in pregnant women with weaker family function.