Study populations were postpartum mothers who were attending those facilities during data collection period. Therefore, our objective was to see the magnitude of insomnia among postpartum mothers.Īll postpartum mothers who were attended at Felege Hiwot Referral Hospital and (Bahir Dar and Hann) health centers, in Bahir Dar town, for receiving obstetrical services were the source population. For preventing sleep related behavioral problems in our setup, we have to address the magnitude and contributing factors of sleep difficulties, which is untouched in previous studies. Obstetricians should give advice for mothers to make important adjustments in their sleep patterns during the postpartum period to avoiding the negative consequences of sleep disturbances such as dysphoric mood and impaired cognitive function.
There is a paucity study about sleep difficulties in low income countries and there is no information regarding the prevalence and determinant factors of sleep difficulties in developing countries especially in Ethiopia. The prevalence of sleep problem has reached up to 57.7% in seven weeks of postpartum period and 52% in both pre- and postnatal periods. The magnitude of sleep difficulties has reached up to 20% in early postpartum period, and wakefulness after sleep onset during postpartum period, 1 st postpartum week (21.1%), increased compared with late pregnancy (5.4%). Different types of sleep problems can be raised during prenatal period such as symptoms of insomnia 57%, sleep-breathing difficulties 19%, and restless legs syndrome 24%. The magnitude of sleep difficulties during pregnancy is common. Maternal sleep disturbances have a strong negative outcome in maternal perceptions of the mother-infant relationship.
Many maternal related psychosocial factors determine their sleep health, and maternal mental illnesses also have a remarkable contribution for the occurrence of sleep difficulties. Even compared with their late pregnancy, total sleep time and sleep efficiency deteriorated significantly from the delivery week to the 12 th postpartum week of their postpartum periods. Most women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout their pregnancy period and this disturbance may be continued during their postpartum period. Mothers with sleep difficulties suffer from different disabilities which are associated with their infant's behavioral health. Maternal sleep deprivation in the early weeks of postpartum period has a significant impact on infants' behavior. The child's attachment with the mother and mother's behavioral health are influential to the child's psychosocial functioning in relation to the development of behavioral disturbances. This behavior is new and causes disturbance of natural sleep-wake cycle. After giving birth, mothers are forced to awake at night to take care of their babies. Sleep difficulties during or before postpartum period are a serious maternal health issue which occurs at a crucial time in mothers' life and ends with various adverse effects on partners and the emotional, behavioral, and sleep difficulties of infants.
Hormonal changes in the immediate postpartum period like decline of progesterone due to its sedative properties and changes in melatonin levels can affect circadian rhythms within the first 3 months and have been implicated in women's postpartum sleep difficulties. Circadian rhythms which are regulated by the body's internal master clock in the brain are influenced by this hormonal disturbance. Postpartum period has a link with the neurobiological mechanisms and there is elevation of monoamine oxidase, decrement of estrogen levels during the first week of postpartum period, and alteration of sleep pattern with other behavioral disturbances. Postpartum period is a state of instability and is accompanied by mood liability, anxiety, insomnia, poor appetite, and irritability. Maternal mental health and related infants' developmental problems become the major reproductive health problems in low income countries.
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