Sleep quality after caesarean delivery: associated factors and effects on quality of life and early breastfeeding

Abstract

BACKGROUND: We investigated the prevalence and associated factors of poor sleep quality after caesarean delivery on the first postoperative night. We also evaluated its impact on quality of life and early breastfeeding effectiveness. METHODS: This single-centre, cross-sectional study collected data from February 2023 to March 2024. We enrolled patients who underwent caesarean delivery under spinal anaesthesia. We gathered perioperative data and utilized the Thai version of the Richards-Campbell Sleep Quality Questionnaire (RCSQ) to evaluate sleep quality. An overall score of below 50 indicated poor sleep quality. The Thai version of the EuroQol Five Dimensions Five Levels (EQ-5D-5L) questionnaire was used to assess quality of life, and the latch, audible swallowing, type of nipple, comfort and hold (positioning) (LATCH) score was employed to evaluate breastfeeding effectiveness. Multivariable logistic regression models were used to analyse associated factors, with data presented as adjusted odds ratios with 95% confidence intervals. RESULTS: The analysis included 284 patients. Seventy-nine patients (27.8%) demonstrated poor sleep quality after caesarean delivery. Three independent factors correlated with poor sleep quality were maternal age ≥35 years (1.880 [1.086-3.252], P = 0.024), urgent/emergency caesarean delivery (1.998 [1.098-3.637], P = 0.023) and moderate to severe pain (numerical rating scale ≥ 4; 1.718 [1.001-2.948], P < 0.049). The Spearman's rank correlation coefficient between the EQ-5D-5L health scale score and the RCSQ score was 0.442 (P < 0.001). The LATCH scores and hospital stay durations were not significantly different between the groups. CONCLUSION: The findings underscore the importance of recognizing patients at higher risk for poor sleep quality. Careful pain monitoring, timely support for urgent or emergency cases and early identification of potential sleep disturbances may guide individualized postoperative care.