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Miller HE, Simpson SL, Hurtado J, Boncompagni A, Chueh J, Shu CH, Barwick F, Leonard SA, Carvalho B, Sultan P, Aghaeepour N, Druzin M, Panelli DM. Associations between anxiety, sleep, and blood pressure parameters in pregnancy: a prospective pilot cohort study. BMC Pregnancy Childbirth 2024; 24:366. [PMID: 38750438 PMCID: PMC11094949 DOI: 10.1186/s12884-024-06540-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/24/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The potential effect modification of sleep on the relationship between anxiety and elevated blood pressure (BP) in pregnancy is understudied. We evaluated the relationship between anxiety, insomnia, and short sleep duration, as well as any interaction effects between these variables, on BP during pregnancy. METHODS This was a prospective pilot cohort of pregnant people between 23 to 36 weeks' gestation at a single institution between 2021 and 2022. Standardized questionnaires were used to measure clinical insomnia and anxiety. Objective sleep duration was measured using a wrist-worn actigraphy device. Primary outcomes were systolic (SBP), diastolic (DBP), and mean (MAP) non-invasive BP measurements. Separate sequential multivariable linear regression models fit with generalized estimating equations (GEE) were used to separately assess associations between anxiety (independent variable) and each BP parameter (dependent variables), after adjusting for potential confounders (Model 1). Additional analyses were conducted adding insomnia and the interaction between anxiety and insomnia as independent variables (Model 2), and adding short sleep duration and the interaction between anxiety and short sleep duration as independent variables (Model 3), to evaluate any moderating effects on BP parameters. RESULTS Among the 60 participants who completed the study, 15 (25%) screened positive for anxiety, 11 (18%) had subjective insomnia, and 34 (59%) had objective short sleep duration. In Model 1, increased anxiety was not associated with increases in any BP parameters. When subjective insomnia was included in Model 2, increased DBP and MAP was significantly associated with anxiety (DBP: β 6.1, p = 0.01, MAP: β 6.2 p < 0.01). When short sleep was included in Model 3, all BP parameters were significantly associated with anxiety (SBP: β 9.6, p = 0.01, DBP: β 8.1, p < 0.001, and MAP: β 8.8, p < 0.001). No moderating effects were detected between insomnia and anxiety (p interactions: SBP 0.80, DBP 0.60, MAP 0.32) or between short sleep duration and anxiety (p interactions: SBP 0.12, DBP 0.24, MAP 0.13) on BP. CONCLUSIONS When including either subjective insomnia or objective short sleep duration, pregnant people with anxiety had 5.1-9.6 mmHg higher SBP, 6.1-8.1 mmHg higher DBP, and 6.2-8.8 mmHg higher MAP than people without anxiety.
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Affiliation(s)
- Hayley E Miller
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA.
| | - Samantha L Simpson
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Janet Hurtado
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | | | - Jane Chueh
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Chi-Hung Shu
- Department of Anesthesiology, Division of Obstetric Anesthesiology and Maternal Health, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Fiona Barwick
- Department of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Stephanie A Leonard
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Brendan Carvalho
- Department of Anesthesiology, Division of Obstetric Anesthesiology and Maternal Health, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Pervez Sultan
- Department of Anesthesiology, Division of Obstetric Anesthesiology and Maternal Health, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nima Aghaeepour
- Department of Anesthesiology, Division of Obstetric Anesthesiology and Maternal Health, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Maurice Druzin
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Danielle M Panelli
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Obstetrics, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
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Hoyniak CP, Whalen DJ, Luby JL, Barch DM, Miller JP, Zhao P, Triplett RL, Ju YE, Smyser CD, Warner B, Rogers CE, Herzog ED, England SK. Sleep and circadian rhythms during pregnancy, social disadvantage, and alterations in brain development in neonates. Dev Sci 2024; 27:e13456. [PMID: 37902111 PMCID: PMC10997484 DOI: 10.1111/desc.13456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/31/2023]
Abstract
Pregnant women in poverty may be especially likely to experience sleep and circadian rhythm disturbances, which may have downstream effects on fetal neurodevelopment. However, the associations between sleep and circadian rhythm disturbances, social disadvantage during pregnancy, and neonatal brain structure remains poorly understood. The current study explored the association between maternal sleep and circadian rhythm disturbances during pregnancy and neonatal brain outcomes, examining sleep and circadian rhythm disturbances as a mediator of the effect of social disadvantage during pregnancy on infant structural brain outcomes. The study included 148 mother-infant dyads, recruited during early pregnancy, who had both actigraphy and neuroimaging data. Mothers' sleep was assessed throughout their pregnancy using actigraphy, and neonates underwent brain magnetic resonance imaging in the first weeks of life. Neonatal structural brain outcomes included cortical gray matter, subcortical gray matter, and white matter volumes along with a measure of the total surface area of the cortex. Neonates of mothers who experienced greater inter-daily deviations in sleep duration had smaller total cortical gray and white matter volumes and reduced cortical surface areas. Neonates of mothers who had higher levels of circadian misalignment and later sleep timing during pregnancy showed smaller subcortical gray matter volumes. Inter-daily deviations in sleep duration during pregnancy mediated the association between maternal social disadvantage and neonatal structural brain outcomes. Findings highlight the importance of regularity and rhythmicity in sleep schedules during pregnancy and bring to light the role of chronodisruption as a potential mechanism underlying the deleterious neurodevelopmental effects of prenatal adversity. RESEARCH HIGHLIGHTS: Social disadvantage was associated with sleep and circadian rhythm disturbances during pregnancy, including later sleep schedules, increased variability in sleep duration, circadian misalignment, and a higher proportion of the sleep period spent awake. Maternal sleep and circadian rhythm disturbances during pregnancy were associated with decreased brain volume and reduced cortical surface area in neonates. Maternal inter-daily deviations in sleep duration during pregnancy mediated the association between social disadvantage and neonatal brain volume and cortical surface area.
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Affiliation(s)
- Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- The Program in Neuroscience, Washington University in St. Louis, St Louis, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St Louis, USA
- Department of Radiology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - J Philip Miller
- Department of Biostatistics, Washington University in St. Louis, St Louis, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Regina L Triplett
- Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Yo-El Ju
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Christopher D Smyser
- Department of Radiology, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Barbara Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Erik D Herzog
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Biology, Washington University in St. Louis, St Louis, USA
| | - Sarah K England
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St Louis, USA
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Loret de Mola C, Carpena MX, Dias IM, Meucci R, Goicochea-Romero A, Cesar J. Sleep and its association with depressive and anxiety symptoms during the last weeks of pregnancy: A population-based study. Sleep Health 2023; 9:482-488. [PMID: 37391279 DOI: 10.1016/j.sleh.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE To evaluate the association between sleep characteristics and depressive and anxiety symptoms during the immediate postpartum period. METHODS People who had hospital births during 2019 in the municipality of Rio Grande (southern Brazil) were assessed with a standardized questionnaire concerning sociodemographic (eg, age and self-reported skin color) and health-related variables (eg, parity and stillbirth) (n = 2314) 24-48 hours after birth. We used the Munich Chronotype Questionnaire to assess sleep latency, inertia, duration, and chronotype; the Edinburgh Postpartum Depression Scale for depressive symptoms; and the General Anxiety Disorder 7-Item Scale to evaluate anxiety symptoms. We used logistic regression models to calculate odds ratios. RESULTS The prevalence of depressive symptoms was 13.7%, and of anxiety symptoms was 10.7%. Depressive symptoms were more likely in those with vespertine chronotype (odds ratios = 1.63; 95% CI: 1.14-2.35) and those with a sleep latency of more than 30 minutes (OR = 2.36; 95% CI: 1.68-3.32). The probability of depressive symptoms decreased by 16% for each additional hour of sleep (OR = 0.84; 95% CI: 0.77-0.92). Sleep inertia of 11-30 minutes increased the probability of anxiety on free days (OR = 1.73; 95% CI: 1.27-2.36) and increased the probability of depressive (OR = 2.68; 95% CI: 1.82-3.83) and anxiety symptoms (OR = 1.69; 95%CI: 1.16-2.44) on workdays. CONCLUSION Participants with vespertine chronotype or shorter sleep duration were more likely to have depressive symptoms. Those who took more time to fall asleep or get out of bed were more likely to have both anxiety and depressive symptoms, but the association was stronger for depressive symptoms.
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Affiliation(s)
- Christian Loret de Mola
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil; Grupo de Pesquisa e Inovação em Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil; Universidad Cientifica del Sur, Lima, Peru.
| | - Marina X Carpena
- Grupo de Pesquisa e Inovação em Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil; Programa de Pós-Graduação em Epidemiologia da Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Ingrid Moura Dias
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil
| | - Rodrigo Meucci
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil
| | | | - Juraci Cesar
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil
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Yang CL, Jansen EC, Dunietz GL, Hirko K, O'Brien LM, Kerver JM. Sleep Disparities Across Pregnancy: A Michigan Cohort Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:219-231. [PMID: 37252253 PMCID: PMC10210214 DOI: 10.1089/whr.2023.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/31/2023]
Abstract
Introduction Poor sleep health during pregnancy is related to adverse pregnancy outcomes. This study aims to identify sociodemographic characteristics associated with sleep health during pregnancy and to examine how they relate to changes in sleep during pregnancy. Materials and Methods Participants (n = 458) were from the Michigan Archive for Research on Child Health, which is a prospective pregnancy cohort. Sociodemographic characteristics and self-reported sleep timing and quality were collected in phone interviews. This longitudinal study collected sleep parameters once during the early trimesters and once during the third trimester. Fall asleep and wake-up times were used to calculate sleep duration and sleep midpoint. Results Compared to the third trimester, sleep duration was 12 minutes longer (p = 0.02), fall asleep time was 21 minutes earlier (p < 0.001), and the midpoint of sleep was 12 minutes earlier (p = 0.01) in early trimesters. Shorter sleep duration was noted in younger women. Sleep midpoint was later in those who were younger, overweight, or obese, racial minorities, unmarried, and with lower educational levels or socioeconomic status, and who smoked before pregnancy after adjusting for covariates. After controlling for confounders, women who were not working for pay had higher likelihood of reduced sleep duration, and women who were unmarried were more likely to have a delayed sleep midpoint in the third trimester compared to the early trimesters. Conclusions This study suggests that sleep parameters changed during pregnancy and sleep health differed by sociodemographic characteristics. Understanding sleep disparities could help with early detection of at-risk populations during prenatal care.
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Affiliation(s)
- Chia-Lun Yang
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Erica C. Jansen
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kelly Hirko
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Louise M. O'Brien
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Obstetrics and Gynecology, and University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jean M. Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
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Wang Y, Yuan J, Lin Q, Wang J, Li H, Zhu B. Psychometric evaluation of the Chinese version of Sleep Health Index in pregnant women. Midwifery 2023; 122:103703. [PMID: 37119671 DOI: 10.1016/j.midw.2023.103703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the psychometric properties of the Chinese version of the Sleep Health Index (SHI-C) among pregnant women. DESIGN Cross-sectional design. SETTING Outpatient clinic of three hospitals in China. PARTICIPANTS Pregnant women (N = 264) aged between 18 and 45 years were recruited via convenience sampling. METHODS The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI) were used to measure sleep quality, daytime sleepiness, and insomnia, respectively. The Fatigue Assessment Scale (FAS) and the Edinburgh Postnatal Depression Scale (EPDS) were used to measure fatigue and depression, respectively. Structural validity was assessed via confirmatory factor analysis (CFA). Concurrent and convergent validity were assessed using bivariate correlation analyses. Known-group validity was assessed by comparing the SHI-C score between different groups. Cronbach's α was calculated for reliability. FINDINGS The average sample age was 30.6 years old and their average score of SHI-C was 86.4 (SD 8.2). Based on PSQI, ISI, and ESS, 43.6%, 32.2%, and 26.9% had poor sleep quality, insomnia, and excessive daytime sleepiness, respectively. The SHI-C total and sleep quality sub-index scores had moderate to strong correlations with both PSQI (r=-0.542, p<0.01; r=-0.648, p<0.01) and ISI (r=-0.692, p<0.01; r=-0.752, p<0.01). The SHI-C total and sleep quality sub-index scores were significantly associated with ESS, FAS, and EPDS (r=-0.171 to -0.276; p<0.01). The SHI-C total score was higher in the second trimester and among those who were working, never drank coffee, or took a nap every day. The Cronbach's α of the SHI-C total and the sleep quality sub-index were 0.723 and 0.806, respectively. The Cronbach's α of sleep duration and disordered sleep sub-indices were 0.594 and 0.545, respectively. KEY CONCLUSIONS Overall, the SHI-C has good validity and acceptable reliability among the pregnant population in China. It can be a useful tool for the assessment of sleep health. More research is warranted to refine the sleep duration and disordered sleep sub-indices. IMPLICATIONS FOR PRACTICE The use of SHI-C would facilitate the assessment of sleep health among pregnant women, which could contribute to the promotion of perinatal care.
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Affiliation(s)
- Yueying Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jinjin Yuan
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Qin Lin
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinle Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Li
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
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Andrade Correia LT, Coimbra DG, Gitaí DLG, Gitaí LLG, de Andrade TG. Associations between chronotype, sleep quality, maternal mental health, and child development in mother-infant dyads. Sleep Med 2023; 106:90-96. [PMID: 37075531 DOI: 10.1016/j.sleep.2023.03.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/06/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE/BACKGROUND Studies on circadian rhythms throughout development and their physiological and behavioral impacts at early stages are still scarce. Previous studies have shown that mother-infant interactions are important for both sleep and child development. In this cross-sectional study we investigated whether infants' chronotype, sleep and development were associated with their respective mothers' chronotype, sleep, mental health and socioeconomic status. PATIENTS/METHODS the following were used to evaluate mothers: the Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Self-Reporting Questionnaire 20 (SRQ-20). To assess the infants' characteristics, the following were used: the 19th question from the Morningness-Eveningness Questionnaire (MEQ), infant nocturnal midpoint of sleep (iMSF), Brief Infant Sleep Questionnaire (BISQ) and Ages and Stages Questionnaire-3 (ASQ3). Socioeconomic aspects were assessed using the Brazilian Economic Class Criterion of the Brazilian Association of Research Companies (ABEP). RESULTS A hundred and eight mother-infant dyads participated in the study. Sleep disorders were observed in 38 (35%) infants and atypical development (ASQ3) in 35 (32%). The infants' sleep phases were partially explained by the mother's chronotype. Infants' sleep duration was negatively correlated with sleep latency, which was higher in the group with atypical development. Mothers of infants with sleep disorders or discordant chronotypes (32%) had higher Pittsburgh scores (worse sleep quality) and higher SRQ-20 scores (screen for Common Mental Disorders). CONCLUSIONS We found evidence for the contribution of sleep quality and chronotypes to mothers' mental health and infant development. However, further studies are needed to confirm the influence of sleep and circadian phenotypes in the early stages.
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Affiliation(s)
| | - Daniel Gomes Coimbra
- Circadian Medicine Center, Faculty of Medicine, Federal University of Alagoas, Maceió, Alagoas, Brazil.
| | - Daniel Leite Góes Gitaí
- Department of Cellular and Molecular Biology, Institute of Biological Sciences and Health, Federal University of Alagoas, Brazil.
| | - Lívia Leite Góes Gitaí
- Circadian Medicine Center, Faculty of Medicine, Federal University of Alagoas, Maceió, Alagoas, Brazil.
| | - Tiago Gomes de Andrade
- Circadian Medicine Center, Faculty of Medicine, Federal University of Alagoas, Maceió, Alagoas, Brazil.
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Kawakami SI, Ikegami A, Komada Y. Sleep habits and problems across gestational progress in Japanese women. J Obstet Gynaecol Res 2023; 49:1137-1143. [PMID: 36746646 DOI: 10.1111/jog.15573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/20/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Pregnancy-related anatomic, physiologic, and hormonal factors can occur at different stages of pregnancy and affect sleep disturbances. Sleep problems and habits among Japanese women across gestational stages have not been described. This study aimed to elucidate sleep problems, including a high risk of sleep-disordered breathing and sleep habits, among Japanese women across gestational progress, including postpartum. METHODS A questionnaire survey using the Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire was conducted for 683 pregnant women (223 in the second trimester, 453 in the third trimester) and 386 postpartum (within 1 week after delivery). RESULTS The total PSQI score was 5.3 [2.6] in the second trimester, 6.1 [2.8] in the third trimester, and 6.8 [3.1] in the first week postpartum. The percentage of those at high risk for sleep-disordered breathing, as determined by the Berlin Questionnaire, was 11.8% in the second trimester, 21.3% in the third trimester, and 19.2% in the first week postpartum, with the highest percentage of those at high risk in the third trimester of pregnancy. CONCLUSION The PSQI total score exceeded the cut-off value in the third trimester and the first week postpartum, suggesting sleep deterioration. Therefore, it is necessary to understand and support sleep in pregnant women to ensure safe delivery, postpartum recovery, and health.
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Affiliation(s)
| | | | - Yoko Komada
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
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Guo Y, Xu Q, Dutt N, Kehoe P, Qu A. Longitudinal changes in objective sleep parameters during pregnancy. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231190952. [PMID: 37650368 PMCID: PMC10475261 DOI: 10.1177/17455057231190952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Sleep disturbances are associated with adverse perinatal outcomes. Thus, it is necessary to understand the continuous patterns of sleep during pregnancy and how moderators such as maternal age and pre-pregnancy body mass index impact sleep. OBJECTIVE This study aimed to examine the continuous changes in sleep parameters objectively (i.e. sleep stages, total sleep time, and awake time) in pregnant women and to describe the impact of maternal age and/or pre-pregnancy body mass index as moderators of these objective sleep parameters. DESIGN This was a longitudinal observational design. METHODS Seventeen women with a singleton pregnancy participated in this study. Mixed model repeated measures were used to describe weekly patterns, while aggregated changes describe these three pregnancy periods (10-19, 20-29, and 30-39 gestational weeks). RESULTS For the weekly patterns, we found significantly decreased deep (1.26 ± 0.18 min/week, p < 0.001), light (0.72 ± 0.37 min/week, p = 0.05), and total sleep time (1.56 ± 0.47 min/week, p < 0.001) as well as increased awake time (1.32 ± 0.34 min/week, p < 0.001). For the aggregated changes, we found similar patterns to weekly changes. Women (⩾30 years) had an even greater decrease in deep sleep (1.50 ± 0.22 min/week, p < 0.001) than those younger (0.84 ± 0.29 min/week, p = 0.04). Women who were both overweight/obese and ⩾30 years experienced an increase in rapid eye movement sleep (0.84 ± 0.31 min/week, p = 0.008), but those of normal weight (<30 years) did not. CONCLUSION This study appears to be the first to describe continuous changes in sleep parameters during pregnancy at home. Our study provides preliminary evidence that sleep parameters could be potential non-invasive physiological markers predicting perinatal outcomes.
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Affiliation(s)
- Yuqing Guo
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, USA
| | - Qi Xu
- Department of Statistics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, USA
| | - Nikil Dutt
- Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, USA
| | - Priscilla Kehoe
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, USA
| | - Annie Qu
- Department of Statistics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, USA
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Al-Musharaf S. Changes in Sleep Patterns during Pregnancy and Predictive Factors: A Longitudinal Study in Saudi Women. Nutrients 2022; 14:nu14132633. [PMID: 35807814 PMCID: PMC9268456 DOI: 10.3390/nu14132633] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess sleep patterns during the three trimesters of pregnancy and whether vitamin D concentrations, along with other risk factors, are associated with these alterations. In a longitudinal study, 140 pregnant women (age 18 to 39 years) were followed throughout their first, second, and third trimesters. Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) at each trimester, along with an assessment of biochemical parameters, including serum vitamin D levels. The information that was collected included anthropometric data, socio-economic status, dietary intake, and physical activity. The PSQI was higher in mid and late pregnancy than in early pregnancy (both p = 0.001), and the sleep duration was also higher in late versus early pregnancy. Linear regression analyses revealed independent predictors of deteriorating sleep quality from early to late pregnancy, including low income (B ± SE −0.60 ± 0.26, p = 0.03) and low serum vitamin D levels in the second trimester (B ± SE −0.20 ± 0.01, p = 0.04). Energy intake and sitting in the second half of pregnancy were positively associated with changes in the PSQI score from the second to third trimesters (B ± SE 0.15 ± 0.07, p = 0.048) and (B ± SE 0.01 ± 0.00, p = 0.044), respectively. Low socio-economic status, low serum vitamin D levels, greater energy intake, and sitting time were associated with worsening patterns of sleep quality from early to late pregnancy.
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Affiliation(s)
- Sara Al-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
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