Sleep is a key yet underappreciated mechanism that has a long-term impact on mental and physical health. Consequences of poor quality of sleep can include diabetes, heart attack, depression, and anxiety. Likewise, those who have faced traumatic experiences throughout their lifetime can experience mental and physical health setbacks, including poor sleep quality. One group of individuals who are especially prone to encountering poor sleep quality are pregnant women, especially those who have experienced trauma. Understanding the relation between maternal trauma history and prenatal sleep quality is vital because of its effects on fetal development, maternal health, and later parenting outcomes. More specifically, women's experiences with trauma have been linked to their sleep quality during pregnancy; however, limited research has examined if the relation between maternal trauma history and prenatal sleep quality varies based on levels of prenatal emotion dysregulation. For instance, it may be that traumatic life experiences negatively influence sleep quality only among women who also have difficulties regulating their emotions. For us to address this gap in the literature, we had 86 women aged 19-38 who were enrolled in a longitudinal study on sleep, emotion dysregulation, and suicide risk during the perinatal period fill out a variety of self-report measures (F31MH124275, PI Kaliush). The participants completed self-report measures pertaining to traumatic life experiences (Traumatic Experiences of Betrayal across the Lifespan [TEBL]; Kaliush et al., unpublished), emotion dysregulation (Difficulties in Emotion Regulation Scale [DERS]; Gratz & Roemer, 2004), and subjective sleep quality (Consensus Sleep Diary [CSD]; Carney et al., 2012). We ran correlational analyses to investigate overall associations among the variables of interest. Hierarchical linear regression was used to test emotion dysregulation as a moderator of the predictive association between maternal trauma history and prenatal sleep quality. We hypothesized a negative correlation between emotion dysregulation and prenatal sleep quality, and a positive correlation between maternal trauma history and the mother's emotion dysregulation. We also hypothesized the relation between maternal trauma history and prenatal sleep quality would vary based on levels of prenatal emotion dysregulation. We hypothesized that high accumulation of trauma would be associated with poor sleep quality only among women who also experienced high emotion dysregulation. Similarly, we hypothesized that regardless of trauma history, women with high emotion dysregulation would have poor sleep quality. Understanding the relation between women's trauma history and prenatal sleep quality-and how this relation may differ based on women's difficulties with emotion regulation-can inform intervention efforts that promote long-term maternal, child, and family health outcomes.
Keywords: emotion dysregulation, pregnancy, sleep quality, trauma