The Best Thing You Can Do To Prevent PPD Is Protect Your Sleep

From the time your algorithm clocks that you’re pregnant, it begins: the slow trickling in of baby care content. Before long, maybe even without realizing it, your entire feed is latching infographics and sleep consultants, all with the vague promise of optimizing your life with a newborn. The truth is there isn’t much you can or should even try to control about your baby’s sleeping and waking patterns for the first six to eight weeks — it simply won’t work. What you can do, is try to make sure that you get some sleep.

In all of the debate about when and how to sleep train, there’s rarely a place in the conversation for maternal or paternal well-being, despite the fact that lack of sleep and poor sleep quality increases the risk of a perinatal mood and anxiety disorder (PMAD). Experts in pediatric sleep and mental health agree that while you can’t control a newborn’s sleeping patterns, parents can and should focus their efforts on protecting and defending their own sleep however they can.

“Lack of sleep directly exacerbates both postpartum anxiety, depression, and OCD,” says Ann Marie Miner, Psy.D., a Portland-based licensed psychologist specializing in perinatal mental health. “Getting sleep is part of how we restore our mental, physical, and emotional resources, and it’s what gives us the ability to feel like it’s a new day when the sun comes up. But when you don’t have that restoration, it just feels like the continuation of another day and another day and another day. It’s like quicksand.” A 2024 study in the Journal of Clinical Sleep Medicine suggests that how our children sleep has deep, long-lasting ties to parents’ mental health: It concluded that even the sleep patterns of a parent’s adolescent child affect maternal depression and parenting behavior.

The idea that getting enough sleep is crucial to mental health seems almost self-evident, but Miner can even pinpoint how long it takes for adequate sleep to restore a client’s well-being: “Four days,” Miner says without missing a beat. “If somebody can get real sleep for three days in a row, ideally four days in a row, I will see a dramatic shift in their mood.” In serious cases of postpartum depression, anxiety, or OCD, ones where the parent may require medication, sleep alone may not put the sparkle back in their eyes. But even for these moms and dads, Miner says, she’ll see a “just-noticeable difference, enough for that hopefulness snowball to start rolling and building upon itself.”

“We can’t control others, and you definitely can’t control a baby. So, it’s best to focus your efforts on what you can do to maximize your own sleep, because we know it is healing and medicinal, and it can help you feel much better.”

How you’re sleeping postpartum can also be diagnostic, meaning it’s as valuable to pay attention to how you’re sleeping (or not) as it is to track your baby’s naps and wakings. If a new mom is exhausted but often struggles to fall asleep when she has the opportunity, that’s a red flag for Miner. It signals to her to ask more questions and probe the possibility that her client is dealing with postpartum anxiety.

Once you reach sleep training age (around 16 weeks, when babies are generally old enough to self-soothe and require fewer night feedings), you can begin to affect some change — for your baby, yes, but also for yourself. Parents often worry, understandably, whether “cry it out” is right for their baby but it’s worth asking if it’s right for them too. “There’s pretty clear evidence that poor infant sleep is associated with maternal depression, and it makes sense. You’re sleeping worse, you’re more likely to feel depressed. The real benefit of sleep training is the effect on maternal mood, in helping with maternal depression,” says Dr. Craig Canapari, M.D., a board-certified pediatric sleep specialist and director of the Yale Pediatric Sleep Center.

Regardless of whether you sleep train your baby at 4 or 6 months old, or whether you do it at all, it has no lasting impact on how your child will sleep after a year or two, he says. “We can’t control others, and you definitely can’t control a baby. Some babies will respond well to sleep training and some won’t. So, it’s best to focus your efforts on what you can do to maximize your own sleep, because we know it is healing and medicinal, and it can help you feel much better,” says Janette Thames, Psy.D., a licensed psychologist at Baptist Health in Jacksonville, Florida. In fact, Thames says getting adequate sleep can help minimize your risk of developing a PMAD. “We know that sleep helps reduce stress hormones, improves mood, and lowers anxiety.”

Both Miner and Thames tout something Miner calls “protected sleep.” One parent retreats to bed for four to six hours of protected sleep, in which the other parent, a family member or friend, or a night nurse cares for the baby solo. The sleeping parent should be on another floor of the house, wearing earplugs, headphones, or doing whatever it takes to not hear the goings on elsewhere in the house. “No matter how much it’s like, ‘Oh, it’s my time to be sleeping,’ if you hear your baby, the adrenaline shoots through your body. You’re wide awake during the time that you’re supposed to be asleep and you know it and you’re anxious about it,’” Miner says. The goal is to get four to five consecutive hours of sleep, an amount she and Thames both say is enough to boost your mood and increase your tolerance for frustration.

“It’s totally possible for the family to find a way to sleep. It just might not look the way the books tell you that it’s supposed to look.”

And all the good sleep hygiene practices you’re using to lull your baby — turning on white noise, darkening the room and keeping it cool — are techniques you should be using on yourself. Parents also benefit from consistent bedtime routines. “Start minimizing bright lights and blue lights that come from our devices at nighttime. Keep a cool sleep environment, get some purposeful movement in throughout the day. Develop a wind-down period so that you can transition more seamlessly to sleep,” Thames says.

When it comes to the constant heaping-on of sleep advice, perhaps it’s time for new parents to shrug off the burden, or at least apply the same dedication to getting their own rest.

“It gets better,” Miner says. “Even if a baby’s sleep doesn’t get better, you can still build structures and supports in your life that will allow you to still be OK even if baby is just not built to be a sleeper. This idea that everybody has to sleep in their own room all night long and we can’t have pacifiers, and we can’t do this or that, all of that is crazy-making. It’s totally possible for the family to find a way to sleep. It just might not look the way the books tell you that it’s supposed to look, but f*ck the books.”