Cognitive and emotional correlates of sleep in the peripartum period: a systematic review.

BACKGROUND

Sleep plays a key role in cognitive and emotional functioning. Sleep difficulties and psychopathology are more prevalent in women, particularly during sensitive periods such as pregnancy and postpartum. However, limited evidence has focused on the underlying processes linking sleep and psychopathology in the peripartum period.

OBJECTIVES

This systematic review aimed to synthesise evidence on the relationship between sleep outcomes and cognitive/emotional processes in the peripartum period.

METHODS

PubMed, PsycInfo, and Scopus were searched from inception until 11th September 2025. Cross-sectional and longitudinal studies involving adult pregnant women (≥18 years) that examined associations between sleep outcomes and cognitive, emotional, or cognitive-emotional processes were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the AXIS tool for cross-sectional studies and the Newcastle-Ottawa Scale for cohort studies. Due to heterogeneity in outcomes and measures, a narrative synthesis was conducted.

RESULTS

Thirty-three studies involving 16,563 women were included. Cross-sectional evidence showed that poor sleep outcomes were consistently associated with impairments in emotional processes (e.g., mood, emotion regulation) and cognitive-emotional processes (e.g., rumination, worry). Findings for cognitive functions (e.g., memory, cognitive inhibition) were mixed. Limited longitudinal evidence suggested that poor sleep may contribute to alterations in nocturnal rumination, perinatal-focused rumination, and sleep-specific rumination and worry across pregnancy, and alterations in mood, anger, and emotion regulation from pregnancy to the postpartum period.

CONCLUSION

Sleep outcomes are consistently associated with cognitive and emotional functioning during the peripartum period, suggesting that sleep may represent a relevant clinical target for prevention and intervention.