Can better sleep health during pregnancy regulate depressive symptoms in women with a previous history of depression?

Sleep HAPi is an individualised education package of information and strategies for healthy sleep during pregnancy, tailored for each participant in each trimester. Sleep HAPi is an intervention specifically designed for this study and will be used in each of the three intervention weeks; one intervention per trimester (this corresponds to time points 2, 3 and 4 – see ‘Study Process’ document attached to this ANZCTR registration form). The package comprises of: + A booklet providing evidence based material on: * The basic physiology of sleep; * The benefits of healthy sleep and consequences of poor sleep; * The fundamental principles of achieving healthy sleep; * Trimester specific sleep changes and expectations; * Trimester specific sleep suggestions. + A summary of the actigraphy data from the measurement week prior. The package is designed to be expanded on over the three intervention weeks, with the majority of information provided and discussed in the first intervention week, with additional trimester specific information and actigraphy data added as the study, and pregnancy, progress. The study will utilise both subjective and objective measures of sleep. The subjective measures will be obtained from six questionnaires at all six time points (see ‘Study Process’ attached). The first questionnaire at T1 (study commencement) is expected to take 10 minutes, the questionnaire at T2 (11-14 weeks gestation) approximately 30-40 minutes, the questionnaires at T3 (21-24 weeks gestation), T4 (32-35 weeks gestation), T5 (6 weeks postnatal) and T6 (12 weeks postnatal) approximately 20-30 minutes each. The first questionnaire will be completed at the initial meeting with the participant, while the remainder will be posted to the participant for completion in their own time within a specified date range. The objective measures will be obtained from a total of six weeks of actigraphy and sleep diaries at T2, T3 and T4 - two separate weeks at each time point, one before the intervention and one after. The participant will wear an actiwatch and fill out a sleep diary for a seven day period. It is expected that filling out the sleep diaries will take no more than 10 minutes per day. Analysis of the objective and subjective measures will elucidate the participant’s sleep behaviours and patterns, which will then be discussed with the participant during the intervention. Relevant suggestions from the Sleep HAPi booklet will then be explored in an attempt to improve sleep. The actigraphy week immediately following each intervention will indicate adherence and whether the sleep suggestions are improving the participant’s sleep. The interventions are a one-on-one, face-to-face meeting scheduled at T2, T3 and T4. These meetings, delivered by a Sleep Scientist, will take place at either the participant’s home, or at the Sleep/Wake Research Centre’s meeting rooms. The first intervention at T2 is expected to be 60-90 minutes in length, with subsequent interventions at T3 and T4 expected to be 45-60 minutes in length. Intervention fidelity is addressed by having a single researcher delivering the education package. Intervention adherence will be assessed using an action and reflection plan. At each intervention time point, the researcher and participant will discuss and develop a sleep action plan. Actigraphy in the week following the intervention will be assessed to determine adherence to the action plan, and the subsequent intervention will be used to reflect on the effectiveness of the plan.