Research Shows dCBT May Help Prevent Postpartum Depression

Study also suggests link between postpartum depression and insomnia.

A new study found that a form of digital cognitive behavioral therapy (dCBT) may help prevent postpartum depression in women for up to 6 months after they give birth.

The study, which was conducted by researchers at the University of California San Francisco (UCSF), tested the efficacy of Sleepio, a self-paced sleep app and form of dCBT, to determine whether treating insomnia would also help prevent depression in postpartum women.1 The study was a follow-up to a study by UCSF researchers in January 2020,2 which found that dCBT treatment helped reduce insomnia and symptoms of anxiety and depression in participants during pregnancy.1

“We were curious to see whether the benefits of dCBT for insomnia would maintain after the birth of the child, especially given the demands of having a young infant,” said Jennifer Felder, PhD, lead author of the study; assistant professor of psychiatry; and core research faculty at the UCSF Osher Center for Integrative Health, in a press release. “We were particularly excited to see the benefits lasted to 6 months not just for insomnia, but for mental health more broadly.”

In the study, 105 out of 208 participants were randomized to the dCBT treatment, which involved up to 6 20-minute sessions using the Sleepio app. At 3 months postpartum, 4% of participants who had the dCBT treatment were rated as likely depressed, in comparison to 18% of the remaining participants, who received usual treatments such as medication or general sleep hygiene tips from their providers. According to Felder, part of what set the dCBT treatment apart from usual care is that it was more individualized and addressed common causes of insomnia.1

“The magic of the treatment is what happens between sessions—the tactics the participants put into practice, such as keeping a sleep diary, stabilizing their wake time, spending less time in bed tossing and turning, and prioritizing an adequate wind-down before bed,” Felder said in a press release.

With its focus on the connection between postpartum insomnia and depression, the study’s results are significant, as up to 15% of women are affected by postpartum depression; around 38% of pregnant women experience insomnia; and insomnia is associated with a 30% increased risk of pre-term birth.1

“I’ve heard patients say, over and over, that their postpartum mental health began to suffer when their insomnia started, suggesting there is a link,” Felder said in a press release. “We know that postpartum can be a vulnerable time for becoming depressed, and it is possible that this intervention may prevent that.”

References

1. Berthold J. Digital therapy for prenatal insomnia may prevent postpartum depression. News Release. University of California San Francisco. December 15, 2021.

2. Felder JN, Epel ES, Neuhaus J, et al. Efficacy of digital cognitive behavioral therapy for the treatment of insomnia symptoms among pregnant women: a randomized clinical trial [published correction appears in JAMA Psychiatry. 2020 Jul 1;77(7):768]. JAMA Psychiatry. 2020;77(5):484-492.