Unprecedented Insights into Maternal Sleep: A Large-scale Longitudinal Analysis of Real-world Wearable Device Data Before, During, and After Pregnancy
Abstract
Introduction: Current understanding of pregnancy and postpartum sleep is driven by limited lab or self-reported data. Consumer wearable devices may help reveal longitudinal, real-world sleep patterns.
Methods: We analyzed de-identified wearable device data from 2,540 users in the United States and Canada who met strict wear-time requirements (≥80% daily usage for ≥80% of the time periods of interest [12 weeks prepregnancy, throughout pregnancy, and 20 weeks immediately postpartum]). We tracked sleep time and staging using Fitbit devices.
Results: Compared to prepregnancy, total sleep time (TST) increased from an average of 425.3±43.5 min to a peak of 447.6±47.6 min at gestational week 10 with ongoing declines throughout pregnancy. Time in bed (TIB) followed a similar pattern. Increased light sleep drove the initial TST rise. Deep and REM sleep decreased significantly throughout pregnancy, with maximum reductions of 19.2±13.8 min (p<0.01) and 9.0±19.2 min (p<0.01) respectively by pregnancy end. Sleep efficiency also declined slightly during pregnancy (median drop from 88.3% to 86.8%). After delivery, TIB remained below the prepregnancy baseline by 14.7±45.7 min at one year postpartum and 15.2±47.7 min at 1.5 years postpartum.
Conclusion: This unprecedented look at large-scale, real-world sleep and pregnancy patterns revealed a previously unquantified initial increase in sleep followed by decreases in both quantity and quality as pregnancy progresses. Sleep deficits persist for at least 1.5 years postpartum. These quantified trends can assist clinicians and patients in understanding what to expect.
Methods: We analyzed de-identified wearable device data from 2,540 users in the United States and Canada who met strict wear-time requirements (≥80% daily usage for ≥80% of the time periods of interest [12 weeks prepregnancy, throughout pregnancy, and 20 weeks immediately postpartum]). We tracked sleep time and staging using Fitbit devices.
Results: Compared to prepregnancy, total sleep time (TST) increased from an average of 425.3±43.5 min to a peak of 447.6±47.6 min at gestational week 10 with ongoing declines throughout pregnancy. Time in bed (TIB) followed a similar pattern. Increased light sleep drove the initial TST rise. Deep and REM sleep decreased significantly throughout pregnancy, with maximum reductions of 19.2±13.8 min (p<0.01) and 9.0±19.2 min (p<0.01) respectively by pregnancy end. Sleep efficiency also declined slightly during pregnancy (median drop from 88.3% to 86.8%). After delivery, TIB remained below the prepregnancy baseline by 14.7±45.7 min at one year postpartum and 15.2±47.7 min at 1.5 years postpartum.
Conclusion: This unprecedented look at large-scale, real-world sleep and pregnancy patterns revealed a previously unquantified initial increase in sleep followed by decreases in both quantity and quality as pregnancy progresses. Sleep deficits persist for at least 1.5 years postpartum. These quantified trends can assist clinicians and patients in understanding what to expect.
