The Physical and Social Environment of Sleep in Socioeconomically Disadvantaged Postpartum Women

Objective:to describe the physical and social environment of sleep self-management in postpartum socioeconomically disadvantaged women.

Design: Descriptive, exploratory design.

Setting:Participants were recruited in the hospital after giving birth. Data were collected in participant homes after discharge.

Participants: Postpartum women on Medicaid with normal healthy infants.

Methods: Participants completed a survey about features within their physical and social sleep environment at 2 weeks postpartum. Participants then completed 3 days and nights of sleep diaries at 4 and 8 weeks postpartum to document perceived awakenings, select sleep hygiene practices, bed sharing, and reasons for sleep disruption.

Results: The sleep environments of participants were dynamic from night to night. Bed sharing was common with nearly one half of participants sharing with a partner, approximately 25% with the infant, and 20% with older children. Fifty-two percent of participants slept with the television on part (31%) or all (69%) of the night. Eighty-five percent of participants drank caffeine and 24% smoked.

Conclusions: These results inform theory-driven postpartum sleep interventions. Modifications to the physical and social sleep environment that attend specifically to how sleep hygiene and environmental factors are manifested in the postpartum period have the potential to improve sleep for socioeconomically disadvantaged women. Future research is needed to articulate which changes can be effectively self-managed by mothers through nursing interventions.