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Murakami K, Ishikuro M, Obara T, Ueno F, Noda A, Onuma T, Matsuzaki F, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Kikuya M, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Social isolation and insomnia among pregnant women in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Sleep Health 2022; 8:714-720. [PMID: 36229360 DOI: 10.1016/j.sleh.2022.08.007] [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: 01/27/2022] [Revised: 07/25/2022] [Accepted: 08/23/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To estimate the prevalence of insomnia and examine the association between social isolation and insomnia among pregnant women. METHODS This cross-sectional study was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. Pregnant women were recruited at obstetric clinics and hospitals in Miyagi Prefecture, Japan. We analyzed 17,586 women who completed the questionnaires and were allowed to transcribe medical records. Insomnia was defined as the Athens Insomnia Scale score of ≥6. The Lubben Social Network Scale-abbreviated version was used to assess social isolation (defined as scores <12), and its subscales were used to assess marginal family ties and marginal friendship ties. Multiple logistic regression analyses were conducted to examine the association between social isolation and insomnia during pregnancy, adjusting for age, parity, prepregnancy body mass index, feelings toward pregnancy, education, income, work status, morning sickness, and psychological distress. Multiple logistic regression analyses were also conducted for marginal family ties and marginal friendship ties. RESULTS The prevalence of insomnia in the second trimester was 37.3%. Women who were socially isolated were more likely to have insomnia than women who were socially integrated: the multivariate-adjusted odds ratio (OR) was 1.26 (95% confidence interval [CI], 1.16-1.36). Marginal family ties and marginal friendship ties were also associated with increased risks of insomnia: the multivariate-adjusted ORs were 1.40 (95% CI, 1.25-1.56) and 1.15 (95% CI, 1.07-1.24), respectively. CONCLUSIONS Social isolation from family and friends was associated with increased risks of insomnia among pregnant women.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Fumiko Matsuzaki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Saya Kikuchi
- Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Natsuko Kobayashi
- Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Noriyuki Iwama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Teikyo University School of Medicine, Tokyo, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan; International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan
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Pitsillos T, Wikström AK, Skalkidou A, Derntl B, Hallschmid M, Lutz ND, Ngai E, Sundström Poromaa I, Wikman A. Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-partum. Front Glob Womens Health 2022; 2:807817. [PMID: 35174357 PMCID: PMC8841694 DOI: 10.3389/fgwh.2021.807817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/24/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction Sleep problems are common in pregnancy but many studies have relied only on self-reported sleep measures. We studied the association between objectively measured sleep and peripartum depressive symptoms in pregnant women. Material and Methods Sleep was assessed using Actiwatch accelerometers in a sample of 163 pregnant women in the late first (weeks 11–15) or early second trimester (weeks 16–19). Depressive symptoms were assessed in gestational weeks 17, 32 and at 6 weeks post-partum using the Edinburgh Postnatal Depression Scale (EPDS). Multiple linear regression and logistic regression analyses, adjusting for age, BMI, pre-pregnancy smoking, ongoing mental health problems, trimester and season of sleep assessment were carried out to test the association between sleep and depression. Sleep was measured by total sleep time and sleep efficiency, whereas depression was indicated by depressive symptoms and depression caseness. Results are presented as unstandardized beta (B) coefficients or adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results Total sleep time ranged from 3 to 9 h (mean 7.1, SD 0.9) and average sleep efficiency was 83% (SD 6.0). Women with the shortest total sleep time, i.e., in the lowest quartile (<6.66 h), reported higher depressive symptoms during pregnancy (week 17, B = 2.13, 95% CI 0.30–3.96; week 32, B = 1.70, 95% CI 0.03–3.37) but not post-partum. Their probability to screen positive for depression in gestational week 17 was increased more than 3-fold (AOR = 3.46, 95% CI 1.07–11.51) but unchanged with regards to gestational week 32 or 6 weeks post-partum. Sleep efficiency was not associated with depressive symptoms at any stage of pregnancy or post-partum. Discussion In one of the few studies to use objective sleep measures to date, mental health of pregnant women appeared to be affected by shortened sleep, with total sleep time being negatively associated with depressive symptoms in the early second and third trimester. This finding highlights the relevance of identifying and treating sleep impairments in pregnant women early during antenatal care to reduce the risk of concomitant depression.
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Affiliation(s)
- Tryfonas Pitsillos
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
- Lead Graduate School, University of Tübingen, Tübingen, Germany
| | - Manfred Hallschmid
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Nicolas D. Lutz
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Institute of Medical Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Edith Ngai
- Department of Information Technology, Uppsala University, Uppsala, Sweden
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- *Correspondence: Anna Wikman
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