Insomnia, Sleep Apnea, and Circadian Misalignment as a “Three-arm” Contributor to Anxiety and Depression During Pregnancy

Anxiety and depression symptoms often occur during pregnancy. The overlap between symptoms related with pregnancy itself, and concomitant affective disorders can significantly affect the mother’s health, potentially impacting delivery associated outcomes. Controversial issues persist regarding the relationship between sleep disturbance and psychosomatic outcomes during pregnancy. Of interest, a recent study by Lin and colleagues reported a strong association between sleep disturbance, anxiety, and depressive symptoms among pregnant women during the COVID-19 pandemic [1]. Although cross-sectional in nature, the main observations of this study raise important implications regarding the development of sleep disturbances during pregnancy, which may act as an explanatory mechanism for increased risk of psychosocial stress. Importantly, the authors highlighted the potential role of clinical sleep disorders including insomnia, and circadian misalignment on mental and physical health. It is also important to consider the role of obstructive sleep apnea (OSA), as a risk factor for reduced mental health during pregnancy, and the overlap of OSA with other sleep disorders.