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Tsai SY, Lee CN, Wu WW, Landis CA. Sleep Hygiene and Sleep Quality of Third-Trimester Pregnant Women. Res Nurs Health 2015; 39:57-65. [PMID: 26650922 DOI: 10.1002/nur.21705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 12/20/2022]
Abstract
The purpose of this descriptive study was to examine the associations of sleep hygiene and actigraphy measures of sleep with self-reported sleep quality in 197 pregnant women in northern Taiwan. Third-trimester pregnant women completed the Sleep Hygiene Practice Scale (SHPS) and the Pittsburgh Sleep Quality Index (PSQI) as well as the Center for Epidemiologic Studies-Depression Scale (CES-D), and wore an actigraph for 7 consecutive days. Student's t-test was used to compare the SHPS scores and means as well as variability of actigraphy sleep variables between poor sleepers (i.e., PSQI global score >5) and good sleepers (i.e., PSQI global score ≤5). Compared to good sleepers, poor sleepers reported significantly worse sleep hygiene, with higher SHPS scores and higher sleep schedule, arousal-related behavior, and sleep environment subscale scores. Poor sleepers had significantly greater intra-individual variability of sleep onset latency, total nighttime sleep, and wake after sleep onset than good sleepers. In stepwise linear regression, older maternal age (p = .01), fewer employment hours per week (p = .01), higher CES-D total score (p < .01), and higher SHPS arousal-related behavior subscale scores (p < .01) predicted self-reported global sleep quality. Findings support avoiding physically, physiologically, emotionally, or cognitively arousing activities before bedtime as a target for sleep-hygiene intervention in women during pregnancy.
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Affiliation(s)
- Shao-Yu Tsai
- Associate Professor, School of Nursing, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd., Taipei, 10051, Taiwan
| | - Chien-Nan Lee
- Professor, Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
| | - Wei-Wen Wu
- Assistant Professor, Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Carol A Landis
- Professor, Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA
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Van Ravesteyn LM, Tulen JHM, Kamperman AM, Raats ME, Schneider AJT, Birnie E, Steegers EAP, Hoogendijk WJG, Tiemeier HW, Lambregtse-van den Berg MP. Perceived sleep quality is worse than objective parameters of sleep in pregnant women with a mental disorder. J Clin Sleep Med 2014; 10:1137-41. [PMID: 25317095 DOI: 10.5664/jcsm.4118] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Disturbed sleep during pregnancy is associated with adverse obstetric outcomes and less mental well-being. In pregnant women with a mental disorder, who frequently suffer from sleep problems, it is unknown whether predominantly objective or subjective sleep quality is more affected. To clarify this, we compared objective and subjective parameters of sleep quality between patients and healthy controls during pregnancy. METHODS This observational study was embedded in an ongoing study among pregnant women with a mental disorder at the department of Psychiatry of Erasmus University Medical Center Rotterdam, the Netherlands. We compared 21 pregnant women with a confirmed mental disorder with 33 healthy controls (gestational age, 23-29 weeks). To measure objective parameters of sleep quality, all participants continuously wore a wrist actigraph for 7 days and nights. Subjective sleep quality was retrospectively assessed using the Pittsburgh Sleep Quality Index (PSQI) and on a daily basis with the Subjective Sleep Quality-scale (SSQ). Differences in parameters of sleep between patients and controls were tested using a multivariate linear regression analysis adjusted for parity, gestational age, educational level, and employment status. RESULTS Objective parameters of sleep quality and subjective sleep quality as assessed by the PSQI did not differ significantly between patients and controls. Daily sleep reports showed that, relative to controls, patients had a significantly worse average SSQ-score (5.2 vs. 7.6, adjusted β = 0.12, 95%CI = 0.03-0.53, p < 0.01). CONCLUSIONS Our exploratory study suggests that perceived sleep quality reported on a daily basis by pregnant women with a mental disorder is worse than the sleep quality as measured by wrist actigraphy.
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Affiliation(s)
| | - Joke H M Tulen
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Astrid M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Monique E Raats
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A J Tom Schneider
- Department of Obstetrics and Gynaecology, subdivision of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Erwin Birnie
- Institute of Health Management and Policy, Erasmus University, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, subdivision of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henning W Tiemeier
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Mijke P Lambregtse-van den Berg
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands ; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
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The potential value of sleep hygiene for a healthy pregnancy: a brief review. ISRN FAMILY MEDICINE 2014; 2014:928293. [PMID: 24967333 PMCID: PMC4041265 DOI: 10.1155/2014/928293] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 11/12/2013] [Indexed: 12/25/2022]
Abstract
The quality of the intrauterine environment influences maternal-fetal health and also offspring predisposition to obesity and cardiometabolic disease later in life. Several determinants, including but not limited to pregravid obesity and excessive gestational weight gain, alter the developmental milieu, fetal growth, and child obesity risk. However, the role of sleep and its relationship to healthy pregnancy is not fully established. Given the host of psychosocial and physiological complications associated with childhood obesity, targeting the gestational period is purported to be an opportune time for preventive intervention. Many longitudinal studies suggest that short sleep duration is a risk factor for the development of impaired glycemia and obesity. However, there is a dearth of information concerning the role of sleep hygiene and its role in a healthy pregnancy. Reports note disrupted and poorer quality of sleep during gestation and highlight an association between reduced sleep and risk of gestational diabetes mellitus. Given the lack of well-designed human trials assessing the value of sleep and healthy pregnancy outcomes, this review summarizes current evidence which suggests that incorporating sleep recommendations and utilizing time management strategies that encourage a healthful night 's sleep may improve the health of the mom and the baby.
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Herring SJ, Nelson DB, Pien GW, Homko C, Goetzl LM, Davey A, Foster GD. Objectively measured sleep duration and hyperglycemia in pregnancy. Sleep Med 2013; 15:51-5. [PMID: 24239498 DOI: 10.1016/j.sleep.2013.07.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 07/12/2013] [Accepted: 07/16/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Our primary purpose was to assess the impact of objectively measured nighttime sleep duration on gestational glucose tolerance. We additionally examined associations of objectively measured daytime sleep duration and nap frequency on maternal glycemic control. METHODS Sixty-three urban, low-income, pregnant women wore wrist actigraphs for an average of 6 full days in mid-pregnancy prior to screening for hyperglycemia using the 1-h oral glucose tolerance test (OGTT). Correlations of nighttime and daytime sleep durations with 1-h OGTT values were analyzed. Multivariable logistic regression was used to evaluate independent associations between sleep parameters and hyperglycemia, defined as 1-h OGTT values ≥130 mg/dL. RESULTS Mean nighttime sleep duration was 6.9±0.9 h which was inversely correlated with 1-h OGTT values (r=-0.28, P=.03). Shorter nighttime sleep was associated with hyperglycemia, even after controlling for age and body mass index (adjusted odds ratio [OR], 0.2 [95% confidence interval {CI}, 0.1-0.8]). There were no associations of daytime sleep duration and nap frequency with 1-h OGTT values or hyperglycemia. CONCLUSIONS Using objective measures of maternal sleep time, we found that women with shorter nighttime sleep durations had an increased risk for gestational hyperglycemia. Larger prospective studies are needed to confirm our negative daytime sleep findings.
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Affiliation(s)
- Sharon J Herring
- Center for Obesity Research and Education, Department of Medicine, Temple University, Philadelphia, PA, United States; Department of Public Health, Temple University, Philadelphia, PA, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University, Philadelphia, PA, United States.
| | - Deborah B Nelson
- Department of Public Health, Temple University, Philadelphia, PA, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University, Philadelphia, PA, United States
| | - Grace W Pien
- Division of Pulmonary Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Carol Homko
- Center for Obesity Research and Education, Department of Medicine, Temple University, Philadelphia, PA, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University, Philadelphia, PA, United States
| | - Laura M Goetzl
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University, Philadelphia, PA, United States
| | - Adam Davey
- Department of Public Health, Temple University, Philadelphia, PA, United States
| | - Gary D Foster
- Center for Obesity Research and Education, Department of Medicine, Temple University, Philadelphia, PA, United States; Department of Public Health, Temple University, Philadelphia, PA, United States
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