The effect of sleep health behavioral education on the depression of pregnant women with sleep disorders: a randomized control trial

Effectiveness of health literacy and relaxing music on quality of sleep and risk for antenatal depression

Background

Pregnant women experience increased sleep disturbances during the third trimester of their pregnancy, which may result in the development of psychological issues in the perinatal period. There is a dearth of interventional studies that combine health literacy and the provision of music for the benefit of pregnant women in South Asia.

Aim

To determine the effectiveness of a combination of Comprehensive Health literacy And Relaxing Music (CHARM) interventions on quality of sleep and risk for antenatal depression among women visiting antenatal outpatient departments of a tertiary hospital in South India.

Methods

A four-arm parallel-group randomized controlled trial was adopted; 128 low-risk primigravid women were recruited and randomly assigned to the four groups using block randomization. The interventions included relaxing music interventions, comprehensive health-literacy interventions, combinations of both as CHARM interventions, and standard antenatal care. All the interventions were provided for four weeks. The quality of sleep among pregnant women was assessed using the Pittsburgh Sleep Quality Index Scale at baseline and after four weeks of intervention. Women at risk of developing antenatal depression were screened using the Edinburgh Postnatal Depression Scale-Antenatal Version.

Results

Pregnant women who received CHARM interventions had significant improvement in quality of sleep when compared with other interventions (F(3,124) =15.0, P < .001, effect size η p2= 0.27). Also, 38 (29.6%) of the included pregnant women were at risk of developing antenatal depression, which was reduced to 21 (16.4%) following the intervention.

Conclusion

CHARM intervention could promote quality sleep and reduce the risk of developing antenatal depression, thereby improving perinatal mental health.

Is collaborative care a key component for treating pregnant women with psychiatric symptoms (and additional psychosocial problems)? A systematic review

Mental disorders during pregnancy are common, with long-lasting negative effects on mother and child. Treatment of these women is challenging, because of the high incidence of additional psychosocial problems and barriers on population and healthcare level. Collaborative care, collaboration between mental health and obstetric care professionals, may help to overcome these problems. The aim of this review is to review antenatal mental health interventions and analyse the impact of collaborative care. Two independent reviewers searched for RCT's in PubMed, Embase and PsycINFO. Trials studying the effect of psychological or pharmacological interventions on the mental health of pregnant women with psychiatric symptoms (and psychosocial problems) were eligible for inclusion. Two reviewers independently abstracted data and assessed study quality and risk of bias. Each study was scored on collaborative care criteria: multi-professional approach to patient care, structured management plan, scheduled patient follow-ups and enhanced interprofessional communication. Thirty-five studies were included. Most trials studied the effect of cognitive behavioural therapy and interpersonal psychotherapy on antenatal depression. Almost all interventions met at least one collaborative care criteria. Interventions were mostly provided by multiple professionals, but interprofessional communication rarely took place. Interventions that met more criteria did not more often show a positive effect on maternal mental health. There is lack of research on antenatal psychiatric disorders other than depressive and on long-term treatment outcomes. Collaborative care is partly implemented in most current interventions, but more trials (including interprofessional communication) are needed to be conclusive whether collaborative care is a key component in antenatal mental healthcare.

The Preliminary Efficacy of a Sleep Self-management Intervention Using a Personalized Health Monitoring Device during Pregnancy

Background: Sleep disturbances are common during pregnancy and are associated with the development of adverse pregnancy outcomes. Personal health monitors (PHM) can facilitate change in health behaviors, though few studies have examined their use in improving sleep during pregnancy. This pilot study aimed to characterize sleep changes during pregnancy in women participating in a self-management intervention using a PHM.Participants/Methods: Participants with low risk, singleton pregnancies from Western Massachusetts were randomized at 24 weeks gestation to receive sleep education only (n = 12) or sleep education, and PHM intervention (n = 12). The single-session sleep education was given at baseline by a registered nurse. Sleep quality, duration, efficiency, disturbances, daytime sleepiness, and fatigue were assessed at baseline and 12 weeks follow-up using questionnaires. We described mean ± standard deviation within and between-group changes in each sleep outcome from baseline to 12 weeks follow-up.Results: The PHM arm experienced larger sleep quality improvements and daytime sleepiness than the sleep-education only arm, but the differences were not statistically significant. In the PHM arm, the Pittsburgh Sleep Quality Index (PSQI) score decreased (i.e., sleep quality increased) 1.22 ± 2.39 (p = .16), and the Epworth Sleepiness Scale (ESS) score decreased (i.e., daytime sleepiness decreased) 1.11 ± 2.08 (p = .15). In the sleep-education arm PSQI decreased 0.57 ± 2.37 (p = .55) and ESS decreased 1.29 ± 2.93 (p = .29). Neither group experienced statistically significant changes in sleep duration, efficiency, disturbances, or fatigue.Conclusion: Sleep education with PHM may improve or prevent decreases in sleep outcomes during pregnancy. Further investigation in larger trials is warranted.

Investigation the effect of jujube seed capsule on sleep quality of postmenopausal women: A double-blind randomized clinical trial

Bakground and objective

Sleep disorder is among the most common problems in the life of postmenopausal women. Because of the complications of chemical drugs, many women prefer to use herbal supplements for relieving sleep problems. So, the main objective of this study was to determine the effect of the jujube seed capsule on sleep quality in postmenopausal women.

Materials and methods

This study was a double-blind clinical trial conducted on 106 postmenopausal women in Khuzestan province, southwest of Iran. All participants were selected by a simple non-probability sampling method. Data were collected through a demographic data form and the Pittsburgh sleeps quality index (PSQI). Individuals were randomly divided into intervention (n = 53) and control (n = 53) groups. The intervention group received 250 mg oral jujube seed capsule and the control group received a placebo capsule twice a day for 21 days. After the treatment, the PSQI was completed in both intervention and control groups. Data were analyzed using the independent t-test and the Chi-square test using SPSS software version 24, and p-value < 0.05 was considered as the significance level.

Results

The results revealed that after treatment, the mean scores of sleep quality decreased in the intervention and control group. Although this difference was statistically significant in both intervention and control groups (p-value < 0.05), more reduction observed in the intervention group (p-value < 0.001).

Conclusion

Consumption of the jujube seed capsule had a positive impact on improving the sleep quality of postmenopausal women and could be recommended as a useful herbal medication.

Socio-demographic determinants of low sexual desire and hypoactive sexual desire disorder: a population-based study in Iran

Background

Various socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age.

Methods

This was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16–49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables.

Results

The mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD.

Conclusion

Some socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD.

Relationship between sleep characteristics and depressive symptoms in last trimester of pregnancy

BACKGROUND

Sleep problems during pregnancy may cause many complications that reduce quality of life.

AIM

This study aims to determine the relationship between pregnant women's sleep characteristics and depressive symptoms.

METHODS

A hospital-based, cross-sectional study was conducted. Pregnant women were selected from the population by using the an improbable random sampling method. This study sample included 436 pregnant women who met the study's inclusion criteria. To collect data, this study used an information form that was developed by the researcher after reviewing relevant literature, the Women's Health Initiative Insomnia Rating Scale (WHIIRS), and the Beck Depression Inventory (BDI). The researchers used face-to-face interviews method to collect data from the participants, pregnant women who were examined in the polyclinic.

RESULTS

This study found that 36% of participating pregnant women reported insomnia, and 38.1% experienced depressive symptoms. It also determined that participants who had problems with insomnia, who experienced a change in sleep habits, and who did not wake up feeling rested experienced depressive symptoms 1.64, 2.79, and 2.59 times more than those who didn't have these problems, respectively. who experienced a decrease in sleep, who experienced an increase in sleep, and who did not wake up feeling rested experienced depressive symptoms 1.61, 3.22, 3.53, and 2.59 times more, respectively, than those who did not have insomnia, who did not experience a change in sleep habits in pregnancy, and who woke up feeling rested, respectively.

CONCLUSION

This study determined that there is a relationship between insomnia and depressive symptoms and that pregnant women experiencing insomnia presented with more depressive symptoms.

The Effect of Empowerment and Educational Programs on the Quality of Life in Iranian Women with HIV

AIDS affects physical, mental, social, and psychological health status. One of the goals of Health for All in the 21st century is to improve the quality of life. This study is a randomized clinical trial conducted on 120 HIV-positive women. Women were administered assessment questionnaires to be completed during the structured interview. After sample collection, participants were divided randomly into 3 groups by using the table of random numbers, then, respectively, received educational intervention, empowerment program, and routine procedures offered by the center and were followed by refilling the questionnaires 12 weeks after intervention. Depending on the type of data, chi-square, analysis of variance, and paired t test were used, and SPSS version 16 was used for data analysis. The finding showed that knowledge increased after intervention in educational ( P = .02) and empowerment groups ( P = .006); also empowerment group indicated significant difference in psychological ( P = .006) and spiritual ( P = .001) domains and their total quality of life ( P = .004). According to this study, exposing HIV-positive women to empowerment education is effective in improving their quality of life.

Prevalence of sexual dysfunction in women with systemic lupus erythematosus and its related factors

Objectives

Systemic lupus erythematosus (SLE) affects all body organs. This disease has marked physiological, mental, and cognitive effects on the patient and results in sexual dysfunction, depression, and decreased self-confidence. This study was conducted to compare sexual function, depression, anxiety, stress, and the related factors in women suffering from SLE.

Material and methods

In this cross-sectional study, 340 women (170 with SLE and 170 healthy) aged 18–49 years were investigated. Convenience sampling was used to select the participants. In this study, a demographic questionnaire, the Depression, Anxiety, and Stress Scales – 21 Items (DASS-21), and the Female Sexual Function Index (FSFI) were applied. Data were analyzed with SPSS 16 using Spearman’s correlation, χ², Mann-Whitney, covariance, and multiple regression statistics; p-values less than 0.05 were considered significant.

Results

The results showed a significant difference in sexual function between the SLE and healthy groups. According to covariance analysis, the difference remained significant after controlling for confounding factors (stress, depression, anxiety). Moreover, the effect of SLE on the sexual function had a significant correlation with age, life status, number and age of children, economic status, menstruation, duration of marriage, age at diagnosis, disease duration and activity, stress, anxiety, and depression. The results of multiple regression analysis showed that age, disease activity, depression, and life status had the highest correlation with sexual dysfunction in women with SLE.

Conclusions

The results of this study indicated that more attention should be paid to the sexual health of women suffering from SLE as a neglected aspect of their treatment, which requires an interdisciplinary approach to shift the care of these patients from a biomedical model to a biopsychosocial model.

How does health-promoting lifestyle relate to sexual function among women of reproductive age in Iran?

This study aimed to evaluate the relation between health-promoting lifestyle and sexual function among women of reproductive age. In this cross-sectional study, 1200 women were recruited randomly from 10 public health centers in Ahvaz, Iran. A demographic questionnaire, Health Promoting Lifestyle Profile 2 (HPLP2), and Female Sexual Function Index (FSFI) were used for data collection. The inclusion criteria were as follows: women aged 15-45 years, married, monogamous, and having basic literacy. Data were analyzed using Kruskal-Wallis test, chi-square test, Spearman correlation coefficient, and logistic regression. All aspects of sexual function showed a significant relationship with different dimensions of HPLP2, except for pain and physical activity ( p < 0.001). Women who had better self-actualization were more likely to have better sexual function than other women (OR = 1.10, 95% CI: 1.06-1.14, p < 0.001). Other variables like responsibility, interpersonal relations and stress management also showed a significant correlation with sexual function. Results of this study showed that health-promoting lifestyle dimensions are significantly related to all aspects of sexual function in women of reproductive age. Health policy makers should take lifestyle-related factors of reproductive-aged women into account when seeking to improve the sexual wellbeing of this population. Further attention should also be given to assessing the direction of causality.

Disturbed Sleep and Postpartum Depression

The perinatal period introduces a myriad of changes. One important but often overlooked change is an increased reporting of sleep disturbance. Although casually regarded as a consequence of pregnancy or postpartum, there is emerging evidence implicating significant sleep disturbance, characterized by insomnia symptoms and/or poor sleep quality, with adverse outcomes, such as an increase in depressive symptomatology or the development postpartum depression (PPD). Significant consequences may arise as a result including issues with maternal-infant bonding, effective care for the infant, and behavioral or emotional difficulties in the infant. This review discusses the relevant literature as to how disturbed sleep during pregnancy as well as in the postpartum may increase the risk for PPD.