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Evidence Library · Sleep

Sleep when the baby sleeps: almost nobody does, and the study says it is unlikely to fix it

After the second week, the authors report that fewer than half of women nap even once in a whole week, although one week in their own table sits just above half. By four months it is about one in four.

The same study that put monitors on the nights also counted the days. The women kept real-time sleep diaries alongside the wrist monitors. Naps were counted, week by week.

Week after birthShare of women who napped at least once that weekAverage naps that week
266.0%2.9
446.0%2.3
641.3%2.1
845.7%1.6
1234.4%2.1
1626.3%1.2

Read the left column as a running commentary on the advice. By six weeks, when most women are being told to sleep when the baby sleeps, fewer than half of them are managing it once in seven days. By four months it is about one in four. Among the women who did nap in a given week, the naps came to roughly 2.6 hours in total across that whole week.

And the authors add the part that is usually left out. Even if you did nap, they wrote, a brief daytime nap is unlikely to relieve the fragmentation of the night. The advice does not address the mechanism.

66.0%
Napped at least once
Week 2
41.3%
Napped at least once
Week 6
26.3%
Napped at least once
Week 16

Now the other measurement. Ask women rather than monitor them and you get a different, lower number, and both are worth knowing.

Every woman who gave birth at one Norwegian hospital across a year was mailed a questionnaire at seven weeks. 2,830 replied, about two thirds of those contacted. Their average reported night sleep was 6.5 hours, their reported sleep efficiency was 73%, and 57.7% scored above the cut-off for a sleep problem on a standard questionnaire.

A second Norwegian cohort followed the same women from week 32 of pregnancy to eight weeks after birth and then to two years. Here is the distribution at eight weeks, which matters far more than any average.

Norwegian cohort, percentages computed on all women answering at each pointWeek 32 of pregnancy8 weeks after birth2 years after birth
Sleeping under 7 hours27.4%49.8%35.2%
Sleeping 7 to 8 hours31.4%29.8%45.1%
Sleeping 8 hours or more41.2%20.4%19.7%
Meeting a definition of insomnia60.8%59.6%40.8%

Two things in that table are easy to miss. The first is that insomnia was already present in 60.8% of these women in late pregnancy, before the baby arrived. The second is that the two-year column is a two-year column. It is not a twelve-month figure and should not be read as one.

The same cohort separates two problems that get lumped together. Difficulty staying asleep rose from 2.93 to 4.24 days a week between pregnancy and eight weeks. Difficulty falling asleep fell, from 2.69 to 1.45 days a week. Falling asleep is not the problem. Staying asleep is.

Further into the year, a Canadian study followed 181 parents in 117 couples and asked them at 2, 4, 6 and 8 months. Averaged across both parents, reported night sleep was 6.4 hours at 2 months, 6.8 at 4 months, 6.7 at 6 months and 6.7 at 8 months. At two months, 59% were sleeping under 7 hours and 40% were inside the recommended 7 to 9 hour range; by four to eight months, between 53.6% and 55.3% were inside it. That sample was mostly white and highly educated, and the numbers are self-reported.

Do not average these togetherSeven point two hours from a wrist monitor and six and a half hours from a questionnaire are not two attempts at the same number. A monitor scores minutes of sleep inside a bounded night. A questionnaire asks a woman for one number covering a month in which she was woken repeatedly. The honest summary is all three sentences at once: measured, most healthy new mothers get around seven hours of night sleep in the first four months; asked, they say six and a half; and about half of them say they are getting under seven.
Instead of being told to nap"Most women do not manage to nap. What else is there?"
"My problem is that I wake up, not that I cannot fall asleep. Does that change what you would suggest?"
"Is there anything here worth checking for, or is this just what a broken night looks like?"
Where this comes from:
766. Montgomery-Downs HE, Insana SP, Clegg-Kraynok MM, Mancini LM. Normative longitudinal maternal sleep: the first 4 postpartum months. Am J Obstet Gynecol. 2010;203(5):465.e1-7.
767. Dorheim SK, Bondevik GT, Eberhard-Gran M, Bjorvatn B. Sleep and depression in postpartum women: a population-based study. Sleep. 2009;32(7):847-55.
768. Sivertsen B, Hysing M, Dorheim SK, Eberhard-Gran M. Trajectories of maternal sleep problems before and after childbirth: a longitudinal population-based study. BMC Pregnancy Childbirth. 2015;15:129.
771. Kracht CL, Blanchard CM, Symons Downs D, Beauchamp MR, Rhodes RE. New parents' sleep, movement, health, and well-being across the postpartum period. Behav Sleep Med. 2024;22(5):636-49.

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