# Behavioral Sleep Therapies During the Perinatal Period: A Scoping Review

## TL;DR

This review summarizes recent studies on behavioral sleep therapies for sleep problems during pregnancy and after childbirth, finding that CBT-I helps sleep but effects fade early postpartum.

## Contribution

The study provides an updated synthesis of randomized controlled trials on behavioral sleep therapies during the perinatal period since 2020.

## Key findings

- CBT-I improves perinatal sleep but benefits decrease in the early postpartum period.
- Mindfulness-based interventions may reduce insomnia during pregnancy.
- Mental health outcomes from sleep therapies are mixed due to study design differences.

## Abstract

Perinatal insomnia is common and consequential. This review presents findings from randomized controlled trials of behavioral sleep therapies in perinatal samples published since 2020.

Eleven studies were included; seven investigated cognitive behavioral therapy for insomnia (CBT-I) and four investigated mindfulness-based interventions (MBI). CBT-I is effective for improving perinatal sleep. Benefits attenuate in the early postpartum period, and re-emerge around six months postpartum. Impact on mental health outcomes is mixed, possibly due to variations in comparator groups and assessment timepoints. Two of the MBI trials were adequately powered to investigate effects on insomnia severity, and suggest that MBIs may be effective for reducing insomnia during pregnancy.

Future work should evaluate the effectiveness of behavioral sleep therapies in real world settings, examine benefits beyond six months postpartum, evaluate impacts on offspring, conduct rigorous research to better quantify mental health benefits, and elucidate for whom MBI is indicated vs. CBT-I.