0446 Experiences in Perinatal Care: An Examination of Sleep Concern Assessment, Awareness, and Management

Abstract Introduction Sleep disturbances are common during pregnancy and postpartum, yet prolonged sleep disruptions can pose serious health risks. Although behavioral, pharmacological, and complementary treatments, including cognitive-behavioral therapy for insomnia (CBT-I), are effective and safe, sleep problems frequently go unaddressed. Limited research has examined how sleep concerns are discussed and managed in perinatal clinical care. This study evaluated U.S. perinatal individuals’ awareness of treatment options for sleep disturbances. Methods Postpartum individuals (18 years or older) from the U.S. were recruited via email in July 2025 to complete an online survey. Eligibility required giving birth within the past 12 months. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI), categorized as no insomnia, subthreshold (8–14), or clinical (≥15). Participants also reported their familiarity with insomnia treatments and whether healthcare providers inquired about sleep and/or offered treatment recommendations during pregnancy and postpartum visits. Results A total of 527 individuals completed the survey. Participants averaged 33.4±4 years; most were White (74%), employed full time (67.5%), and married (90%). Based on ISI scores, 49.6% reported no insomnia, 34% subthreshold insomnia, and 16.4% clinical insomnia. During pregnancy, 36.7% were asked about sleep and only 10.6% received any treatment recommendation, most commonly over-the-counter (OTC) options (65.4%), followed by relaxation/mindfulness (11.5%) and prescription medications (9.6%). No participants were offered CBT-I. Postpartum, 33.5% were asked about sleep, and only 3.4% received treatment suggestions, again primarily OTC or relaxation-based strategies. Participants were highly familiar with melatonin (84.8%), OTC sleep medications (74.6%), and prescription medications (70.2%). Fewer recognized behavioral treatments: 54.3% were familiar with relaxation or mindfulness therapies, 34.7% with sleep hygiene, 14.4% with CBT-I, 4.4% with stimulus control, and 2.7% with sleep restriction therapy. Conclusion Perinatal sleep disturbances were common, with half of participants reporting at least subthreshold insomnia. Yet only about one-third were asked about sleep, and treatment recommendations were rare, especially postpartum. Critically, despite evidence that CBT-I is effective in this population, no participants received evidence-based behavioral therapies. Support (if any)