A Cross-Sectional Study of Maternal Sleep Quality in the First Two Years of Childcare

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Abstract
BACKGROUND: The postpartum period and early years of motherhood represent a transformative stage in a woman’s life, accompanied by significant physiological, psychological, and social changes. One of the most commonly reported challenges during this period is sleep disruption. Sleep disturbances are common among mothers of young children, yet limited data exist for this issue in the context of North Macedonia. This study explores the prevalence and correlates of poor sleep quality among mothers in the postpartum period. AIM: To assess the sleep patterns, duration, and quality among mothers with young children and identify key demographic, behavioral, and psychosocial factors associated with sleep disturbances. METHODS: A cross-sectional survey was conducted among 648 mothers of children aged 0–2 years in North Macedonia. A structured questionnaire was used to collect data on sleep duration, sleep quality (using the Pittsburgh Sleep Quality Index), and associated factors such as maternal age, number of children, employment status, co-sleeping, and perceived stress. RESULTS: Findings revealed that over 60% of participants reported poor sleep quality, with significant reductions in sleep duration compared to their pre-motherhood period. The most common issues were frequent night awakenings and difficulty falling back asleep. Poor sleep was significantly associated with lack of family support, chronic fatigue, and higher levels of self-reported stress. CONCLUSION: Maternal sleep quality in North Macedonia is substantially affected during early child-rearing years. Tailored interventions focusing on maternal mental health, family support, and sleep hygiene education are needed to improve sleep health in this vulnerable population.

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