Inpatient activity and sleep following vaginal versus scheduled cesarean delivery using actigraphy: an observational pilot study.

BACKGROUND

Sleep and physical activity are key postpartum recovery domains. We compared inpatient postpartum sleep and activity following vaginal and scheduled cesarean deliveries using wrist based actigraphy.

METHODS

This prospective, single center cohort study used actigraphy worn throughout hospitalization to explore differences in inpatient postpartum sleep and activity.

RESULTS

Of 78 patients enrolled, 61 were fully analyzed. Sleep was poor in both groups, (median sleep-bout duration 3.6 h). Sleep efficiency, total sleep time, wake after sleep onset were similar between groups. Average sleep movement index (5.4 vs. 7.2) and sleep fragmentation index (5.6 vs. 19.0) were lower after vaginal than cesarean delivery, but neither difference survived correction for multiple comparisons. Cesarean patients recorded significantly greater sedentary and light activity on days 0-2, these differences remained after correction for multiple comparison.

CONCLUSION

Inpatient sleep was poor in both delivery modes. Sleep restlessness indices were lower after vaginal delivery but non-significant following multiple comparison; greater early sedentary and light activity was greater following cesarean delivery and persisted following correction. The clinical meaningfulness of these exploratory differences are unknown and require confirmation in adequately powered studies.