Postpartum Sleep Effects on Smoking Relapse – The Rest Assured Study

We are recruiting research assistants for this study to clean, enter, analyze and/or assist in writing up findings on baby and mother subjective/sleep log sleep during early postpartum. Email kristen_stone@brown.edu if interested and please include your resume/CV. (If undergrad, please include your GPA or GPA-equivalent.) RAs in the Stone Sleep Lab assist in research activities for a minimum of 10 hours a week for a minimum of one academic year. The location (50 Holden Street) is not within easy walking distance to campus.

Rates of postpartum smoking relapse are high (70-90%) among women who quit smoking in anticipation of or during pregnancy, despite the fact that relapse is unintentional for a substantial number of these women. In addition to well-established health consequences for smokers, maternal smoking poses health risks for infants, including respiratory and gastrointestinal problems. Standard relapse prevention interventions are not effective for postpartum women. Sleep loss and sleep fragmentation, prevalent for the first 3 months postpartum, may contribute to this problem. Poor sleep is known to diminish stress management skills and behavioral coping and may impact relapse prevention among new mothers through these and other mechanisms. The primary goals of this project were 1) to measure unique postpartum factors, such as sleep duration and continuity, to see if those factors affect new mothers' ability to stay smoke-free and 2) to develop, refine, and pilot test an integrative smoking relapse prevention intervention for postpartum women called Rest Assured. The long-term objective of this research is to foster postpartum relapse prevention for women with a history of smoking, which, in turn, would improve the overall health of postpartum women and their families.

Findings: The sleep intervention lengthened maternal nighttime sleep by an average of 48 minutes nightly; lengthened the longest bout of consolidated sleep by an average of 42 minutes nightly; increased sleep efficiency into the healthy range (> 85%); and lowered subjective ratings of sleep disturbance (ps < .05). Findings were inconclusive regarding whether better sleep was associated with abstinence.

Post Hoc analyses identified the presence of an additional support person in the home (e.g., mother) as well as social and emotional support as being positively correlated with smoking abstinence (p < .05; p < .01).

Conclusions: 1) Postpartum sleep can be improved with behavioral interventions in women with a history of smoking. 2) Social-emotional postpartum support is an important factor in preventing smoking relapse for these women. Specifically, having a mother or major support person stay with them during early postpartum may help women who quit smoking for or during pregnancy stay smoke-free.

NIDA Postdoctoral Fellowship, 2007-2009

Early Career Distinguished Research Award, Behavioral Sleep Medicine, 2008

American Academy of Sleep Medicine Abstract Press Release, 2008

GRANTS
1. Validating actigraphic measures of insomnia. Methodist Healthcare Foundation. Total costs, $19,270. 2003-2005, Co-Investigator.
2. Sexual messages and cognitions as contributors to women's sexual contentment. The University of Memphis Psychology Department Dissertation Award. Total costs, $1,500. 2005-2006, Principal Investigator.
3. A tailored Actiwatch algorithm for insomnia. Mini Mitter/ Respironics. Total costs, $ 47,310. (Funded but declined due to dispute over intellectual property rights.) 2006, Co-Investigator.
4. Postpartum sleep effects on smoking relapse (1R21DA026448 – 01). National Institute on Drug Abuse. Total costs, $406,643. 2009-2011. Principal Investigator.

Sleep Research Society

Society of Behavioral Sleep Medicine

International Centre for Excellence in Emotionally Focused Therapy