Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

Theresa Casey, Hui Sun, Helen J. Burgess, Jennifer Crodian, Shelley Dowden, Shelby Cummings, Karen Plaut, David Haas, Lingsong Zhang, Azza Ahmed

Research output: Contribution to journalArticle


Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 (n = 50) and 32 (n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased (p <.05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation (p <.05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation (p <.05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 (p <.05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

Original languageEnglish (US)
Pages (from-to)713-724
Number of pages12
JournalJournal of Human Lactation
Issue number4
StatePublished - Nov 1 2019


  • Breastfeeding
  • lactation
  • lactogenesis
  • maternal physiology

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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