Featured Publications

For a full list of Dr. Felder's publications, please see the All Publications page. 

Felder, J.N., Mirchandaney, R., Harrison, J., Manber, R., Cuneo, J., Krystal, A., Epel, E., & Hecht, F. (Accepted). Examining experiences of poor sleep during pregnancy: A qualitative study to inform the development of a prenatal sleep intervention. Global Advances in Health and Medicine.

The goal of the focus group study was to learn more about pregnant people’s experiences with poor sleep and what they would want from a mindfulness-based program for sleep. For a description of our focus group study, please visit this page of our website.

Felder, J.N., Epel, E.S., Neuhaus, J., Krystal, A.D., & Prather, A.A. (2022). Randomized controlled trial of digital cognitive behavior therapy for prenatal insomnia symptoms: Effects on postpartum insomnia and mental health. SLEEP, 45.

The REST study was a large RCT investigating CBT-I as a behavioral intervention for insomnia. This paper discusses the findings from measures completed in the postpartum period. For a description of the REST study and this paper, please visit this page of our website.

Editorial: Kalmbach, D.A. (2022). The emerging role of prenatal insomnia therapy in the prevention of perinatal depression and anxiety. SLEEP, zsac029.

Felder, J.N., Epel, E., Coccia, M., Cordeiro, A., Laraia, B., Adler, N., Coleman-Phox, K., & Bush, N. (2020). Prenatal maternal objective and subjective stress exposures and rapid infant weight gain. Journal of Pediatrics, 222, 45-51.

This study aimed to examine the relationship between prenatal stress exposures and rapid infant weight gain. Previous research has shown that rapid infant weight gain can be a predictor of childhood obesity, and so it is important to identify potentially malleable risk factors. The study assessed maternal objective stress through retrospective interviews and subjective stress through surveys, while birthweight was obtained from medical records and infants were measured and weighed at 6 months. In total, 28% of the sample met criteria for rapid infant weight gain. Exposure to prenatal stress events was associated with increased odd of rapid infant weight gain (OR 1.40, 95% CI 1.07-1.83, P=.014), while neither prenatal perceived stress nor depressive symptoms were significantly associated with rapid infant weight gain. Future research should evaluate whether prenatal interventions that focus on reducing exposure to stressful events prevent rapid infant weight gain.

Felder, J.N., Epel, E.S., Neuhaus, J., Krystal, A.D., & Prather, A.A. (2020). Efficacy of digital cognitive behavior therapy for the treatment of insomnia symptoms among pregnant women: A randomized clinical trial. JAMA Psychiatry, 77 (5), 484-492.

The REST study was a large RCT investigating CBT-I as a behavioral intervention for insomnia. This paper discusses the efficacy of CBT-I for treatment of prenatal insomnia. For a description of the REST study and this paper, please visit this page of our website.

Felder, J.N., Hartman, A.R., Epel, E.S., & Prather A.A. (2020). Pregnant patient perceptions of provider detection and treatment of insomnia. Behavioral Sleep Medicine, 18 (6), 787-796.

In this survey study of 423 pregnant people, we found that the majority had not discussed their sleep with a health care provider at any point during pregnancy (61%). Participants with moderate-to-severe insomnia symptoms reported that over-the-counter medication was the most common treatment recommendation they received from providers (52%); therapy or counseling were recommended rarely (16%). Assessing insomnia symptoms during pregnancy provides the opportunity to identify and treat a potentially modifiable risk factor for adverse birth and psychological outcomes, but these findings suggest that insomnia may be under-detected and under-treated.

Felder, J.N., Roubinov, D., Bush, N., Coleman-Phox, K., Vieten, C., Laraia, B., Adler, N., & Epel, E. (2018).  Effect of prenatal mindfulness training on depressive symptom severity through 18-months postpartum: A latent class analysis. Journal of Clinical Psychology, 74, 1117-1125.

This was a secondary analysis of the MAMAS Study, which evaluated the impact of an 8-week mindfulness program on psychological distress and excess gestational weight gain in a racially and ethnically diverse, predominantly low income sample of pregnant people. This paper examined depressive symptoms from post-intervention to 18 months postpartum. There were three depressive symptom severity profiles: none-minimal, mild, and moderate. Participants who received prenatal mindfulness training were less likely to be in the moderate profile than the none-minimal profile, suggesting that prenatal mindfulness training may have long-term benefits for mood during the transition to parenthood.

Felder, J.N., Epel, E., Lewis, J.B., Cunningham, S., Tobin, J.N., Schindler Rising, S., Thomas, M., & Ickovics, J.R. (2017). Depressive symptoms and gestational length among pregnant adolescents: Cluster randomized control trial of CenteringPregnancy Plus group prenatal care. Journal of Consulting and Clinical Psychology, 85, 574-584.

The goal of this study was to determine the effects of depressive symptoms on preterm birth and gestational age among pregnant adolescents, who are more likely to have depressive symptoms than adults, as well as less likely to seek treatment. The study also evaluated the impact of group prenatal care vs standard individual prenatal care on perinatal depressive symptoms. Increased depressive symptoms from second to third trimester, and third trimester depressive symptoms, were associated with shorter gestational age at delivery and preterm birth (<37 weeks gestation). Participants randomized to group prenatal care had decreased depressive symptoms, compared to those who received individual care. These results suggest that group prenatal care may be an effective non-pharmacological option for reducing depressive symptoms among perinatal adolescents.

Felder, J.N., Baer, R.J., Rand, L., Jelliffe-Pawlowski, L.L., & Prather, A.A. (2017).  Sleep disorder diagnosis during pregnancy and risk of preterm birth. Obstetrics and Gynecology, 130, 573-581.

The aim of this study was to assess whether a sleep disorder diagnosis during pregnancy is associated with an increased risk of preterm birth. The study found that maternal diagnoses of sleep apnea or insomnia during pregnancy were associated with an increased risk of preterm birth. For example, the prevalence of preterm birth (before 37 weeks of gestations) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis.This research points to the importance of screening for and treating sleep problems during pregnancy. 

Felder, J.N., Laraia, B., Coleman-Phox, K., Bush, N., Suresh, M., Thomas, M., Adler, N., Epel, E., & Prather, A. (2017). Poor sleep quality, psychological distress, and the buffering effect of mindfulness training during pregnancy. Behavioral Sleep Medicine, 16, 611-624.

The current study examines the effects of a mindfulness-based intervention on the relationship between poor sleep quality and increased depression symptom severity and perceived stress during pregnancy, and explores the prevalence of poor sleep quality in this unique sample and the impact of intervention on sleep quality. Participants were 215 ethnically diverse, overweight and obese, predominantly low-income pregnant women drawn from a study examining the impact of an 8-week mindfulness-based program, and most (63%) experienced poor sleep quality. Poor sleep quality was associated with worsening psychological distress, but mindfulness training significantly attenuated the influence of poor sleep on perceived stress.