PONE-D-23-29005Prevalence Of Insomnia And Associated Factors Among Postpartum Mothers in Southern Ethiopia, a community-based cross-sectional study.PLOS ONE

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: - In the abstract, consider one sentence distinguishing insomnia in postpartum from sleep disruption in postpartum due to direct childcare.

- I am not sure about the final sentence of the abstract. It feels strange to me to strongly advise a planned index pregnancy. On what grounds is this recommendation made? Consider amending this language. Correlation does not equate causation.

- P.7 the formatting and capitalization of academic affiliations is not consistent (ex. 1 Department of Midwifery, 2Department of midwifery).

- Introduction- I would consider a different definition of insomnia. The important distinction between postpartum insomnia and postpartum sleep disruption is- is the person having difficulty sleeping, outside of direct childcare. Basically, when given the opportunity, still struggling with their sleep.

- Consider removing this sentence or clarifying what is meant by ‘atypical’- Women have a 40% higher risk and an atypical presentation of insomnia than men (3, 6).

- I like the description of Arba Minch Town.

- P. 14 might be nice to include monthly income converted to USD or another currency so more readers can comprehend.

- P. 18- consider ‘met criteria for insomnia’ rather than ‘had insomnia’

- P. 21- I like the discussion opening, situating the findings in the context of literature from other countries

- P. 22 “This might be due to the definite link between depression and insomnia, as well as insomnia, being a manifestation of depression(30).” Consider amending the language to acknowledge the bi directional relationship for example “This finding may be explained by the well established and bi directional relationship between insomnia and depression.”

- For the conclusion- consider mentioning established implications of insomnia in postpartum.

- Please consider amending this sentence, it is hard to understand “As a result, the sustainable development goals for mental health can be achieved; even if it appears that world leaders are now off-track in achieving mental health targets, and hence, the following recommendations were made for actions to be performed by the stakeholders”.

Reviewer #2: Thank-you for this submission. I was curious about your definition of chronic insomnia - you mention difficulty sleeping that lasts for greater than 3 weeks. The definition I am more familiar with indicates chronicity begins after 3 months - was this a different definition specifically for post-partum patients?

I was impressed with your response rate and that you did a trial run for two weeks to ensure that the data collection was high quality.

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Reviewer #1: No

Reviewer #2: No

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Prevalence Of Insomnia And Associated Factors Among Postpartum Mothers in Southern Ethiopia, a community-based cross-sectional study.

PONE-D-23-29005R1

Dear Dr. Tetema,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Anteneh Mengist Dessie, MPH

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Thank-you for your responses and for addressing the concerns that were raised. We appreciate your recommendation that health care workers ask their patients about their sleep.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

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