This U.S.A.-based study examined the quantitative and qualitative characteristics of sleep, as well as the
role of sleep, in the association of stress with depression, fatigue, and health-related quality of life (HQOL)
among mothers with a low-birth-weight, preterm infant in the neonatal intensive care unit at early
postpartum. Fifty-five first-time mothers kept a sleep diary and filled out a battery of questionnaires. The
wrist actigraphy method was also applied to collect information on maternal sleep. We tested a path
model, with sleep disturbance and depression mediating the effect of stress on health-related well-being.
Results showed that the majority of the study participants were stressed, depressed, fatigued, and at risk
for poor physical and mental health. Poor sleep quality as perceived by mothers was significantly
associated with their stress, fatigue, and poor mental and physical H-QOL. A cascading effect was found
in the path model where maternal stress contributed to poor sleep quality and depression, which in turn
contributed to poor mental H-QOL. In addition, poor sleep quality was associated with fatigue, which in
turn contributed to poor physical and mental H-QOL. The underlying neurobiological mechanisms
through which sleep affects the stressehealth relation are discussed. The implications of sleep for
intervention and prevention are also addressed.
This U.S.A.-based study examined the quantitative and qualitative characteristics of sleep, as well as therole of sleep, in the association of stress with depression, fatigue, and health-related quality of life (HQOL)among mothers with a low-birth-weight, preterm infant in the neonatal intensive care unit at earlypostpartum. Fifty-five first-time mothers kept a sleep diary and filled out a battery of questionnaires. Thewrist actigraphy method was also applied to collect information on maternal sleep. We tested a pathmodel, with sleep disturbance and depression mediating the effect of stress on health-related well-being.Results showed that the majority of the study participants were stressed, depressed, fatigued, and at riskfor poor physical and mental health. Poor sleep quality as perceived by mothers was significantlyassociated with their stress, fatigue, and poor mental and physical H-QOL. A cascading effect was foundin the path model where maternal stress contributed to poor sleep quality and depression, which in turncontributed to poor mental H-QOL. In addition, poor sleep quality was associated with fatigue, which inturn contributed to poor physical and mental H-QOL. The underlying neurobiological mechanismsthrough which sleep affects the stressehealth relation are discussed. The implications of sleep forintervention and prevention are also addressed.
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