JMIR Publications

ABSTRACT

Background:

Both poor sleep health and hypertensive disorders of pregnancy (HDP) are independent risk factors for cardiovascular disease (CVD). Whether poor sleep postpartum contributes to the relationship between HDP and future CVD is unknown.

Objective:

This pilot study evaluated sleep health using a wearable device (Oura ring) among mothers with and without a history of HDP.

Methods:

Women 3–7 years postpartum completed baseline questionnaires (Pittsburgh Sleep Quality Index [PSQI], diet, physical activity) and wore the Oura ring for two weeks to monitor sleep. Optimal sleep health was defined as sleep duration >7 hours, PSQI <5, midpoint between 2:00–4:00 AM, sleep efficiency >85%, and sleep onset variability <60 minutes. Cardiovascular health (CVH) was assessed using the “Life’s Essential 8” score. Semi-structured interviews were conducted.

Results:

28 women with prior HDP and 21 with prior normotensive pregnancy were included. Sleep quality was poor in both groups (median PSQI 7.0 ± 3.5 HDP vs 5.9 ± 2.4 control; p=0.20). Sleep duration overall was 6.7 ± 0.8 hours, with no difference between groups. Nearly half (47%) had abnormal sleep timing, and sleep onset variability was high (1.2 ± 0.5 hours), with no significant differences by HDP status. Mean CVH score fell within the moderate range (70.7 ± 12.8), with no differences between groups. Common barriers to sleep included parenting, work, and household responsibilities.

Conclusions:

Among postpartum women, sleep health was suboptimal regardless of HDP history. Interventions to improve sleep and CVH should target all mothers during the first decade after childbirth.