0410 Characterizing Postpartum Sleep and the Prevalence of Postpartum Insomnia Disorder

Abstract Introduction Poor sleep in the postpartum period is linked to adverse maternal and infant outcomes. However, the prevalence of insomnia disorder in this population remains unclear with estimates ranging from 1.3% to 59.6%(Sultan 2022, Sivertsen 2015). We aimed to determine the prevalence of insomnia disorder and characterize sleep (sleep disturbance (SD) and sleep-related impairment (SRI)) at 6 weeks postpartum. Methods Following IRB approval, patients were recruited in a longitudinal prospective cohort study evaluating newly adapted postpartum PROMIS-SD and SRI surveys. Adults who had delivered a live infant via any delivery mode were approached during delivery admission at two US hospitals (CA and AR) and invited to complete three surveys (Bergen Insomnia Scale(BIS),PROMIS-SD and SRI) at 6 weeks postpartum. Participants were also invited to complete virtual 1 hour structured clinical interviews diagnostic for sleep disorders(SCISD-R, the criterion standard for diagnosing sleep disorders), at 6 weeks postpartum until 150 interviews were completed. Demographic, clinical, and neonatal variables were collected. Primary outcome was prevalence of insomnia disorder based on SIDSD-R. Secondary outcomes were sleep characteristics (sleep satisfaction, quality, duration, latency, awakenings) and survey scores. Descriptive statistics were used to report findings. Results 150 of 413 invited patients (36.3%) completed SCISD-R at 44±7 days postpartum. Among the interviewees, 68 had spontaneous vaginal, 7 operative vaginal, 43 planned and 30 unplanned caesarean deliveries. Mean age was 33±5 years. Through SCISD-R, insomnia disorder was diagnosed in 20 (13%) participants, but only two had received any clinical evaluation for insomnia. Among the 144 surveys completed, median BIS was 20[IQR 14-27], PROMIS-SD T score was 51[IQR 45-56], and SRI T score was 57[IQR 50-62], suggesting normal SD and mild SRI in most participants. “Poor” or “very poor” sleep quality was reported by 29%(43/150), and 51%(74/144) reported they were “not at all” or only “a little” satisfied with their sleep. 85% (129/150) patients reported sleeping < 7 hours a night. Sleep latency ≥30 minutes was reported in 20%(30/150), and 84% (126/150) reported waking 1-4 times nightly. Conclusion Insomnia disorder prevalence at 6 weeks postpartum was 13% using SCISD-R. Most cases were undiagnosed. Improved identification of insomnia disorder in the postpartum period is necessary. Support (if any)