BMC pregnancy and childbirthOct 31, 2024

Genetic links between sleep patterns and postpartum depression in both directions

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Mar 25, 2026

Abstract

Sleep apnea syndrome, sleeplessness/insomnia, and frequency of tiredness are associated with an increased risk of , with odds ratios of 1.122, 1.465, and 1.725, respectively.

Genetic analysis identified sleep apnea syndrome as a risk factor for postpartum depression.
Sleeplessness or insomnia is linked to a higher likelihood of developing postpartum depression.
Increased frequency of tiredness or lethargy in the last two weeks is also associated with postpartum depression.
Postpartum depression may lead to sleeplessness and increased tiredness, indicating a bidirectional relationship.
No significant associations were found between the remaining six sleep traits and postpartum depression.

Simplified

BACKGROUND: (PPD) is widely recognized as the most prevalent mental health crisis following childbirth and has been linked to sleep disturbances. However, the potential causal relationships between various sleep traits and PPD remain unclear. This study employs a bidirectional two-sample (MR) approach to investigate these associations.

METHODS: The inverse-variance-weighted method was used to evaluate the causally linked sleep traits on postpartum depression. The weighted median, weighted mode, and MR-Egger were used to estimate the robustness of the inverse-variance-weighted method. The leave-one-out method estimated the sensitivity of the result. Cochran's Q method was used for the heterogeneous test. The MR-Egger intercept and MR-PRESSO methods detected the horizontal pleiotropy.

RESULTS: We examined the genetic causal relationships between nine sleep traits and postpartum depression. Sleep apnea syndrome (OR: 1.122; 95%CI: 1.063-1.185; p = 0.000), sleeplessness/insomnia (OR: 1.465; 95%CI: 1.104-1.943; p = 0.008), and frequency of tiredness/lethargy in last 2 weeks (OR: 1.725; 95%CI: 1.345-2.213; p = 0.000) genetically predicted the increased risk of postpartum depression. The reverse Mendelian randomization analysis showed PPD caused sleeplessness/insomnia (β: 0.006; 95%CI: 0.001-0.010; p = 0.016) and frequency of tiredness/lethargy in last 2 weeks (β: 0.007; 95%CI: 0.002-0.011; p = 0.004). The remaining six sleep traits showed no significant association with PPD. There was no heterogeneity or horizontal pleiotropy.

CONCLUSIONS: Genetic evidence reveals causal relationships between specific sleep traits and PPD, including sleep apnea syndrome, sleeplessness/insomnia, and tiredness. Whether certain sleep health indicators suggest a risk of postpartum depression or sleep issues that are caused by PPD, both may offer insights into the prevention and treatment of PPD.

Key numbers

1.122×

Increase in risk due to sleep apnea syndrome

Causal association identified using analysis.

1.465×

Increase in risk due to sleeplessness/insomnia

Causal association identified using analysis.

1.725×

Increase in risk due to tiredness/lethargy

Causal association identified using analysis.

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Genetic links between sleep patterns and postpartum depression in both directions

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