بی خوابی در زنان باردار
Abstract
۱٫ Introduction
۲٫ Methods
۳٫ Results
۴٫ Discussion
Funding/Support
Contributors
Declaration of competing interest
References
Abstract
Background: Insomnia is common during pregnancy but the prevalence and risk factors of insomnia in Chinese women during pregnancy is not well studied. This study aimed to examine the prevalence of insomnia and its risk factors in Chinese women during pregnancy. Methods: In this cross sectional study, 436 Chinese pregnant women with Insomnia Severity Index (ISI) ≥ ۸ were clinically assessed using the insomnia criteria based on the combination of DSM-IV (Diagnostic and Statistical Manual-4th Edition) and ICD-10 (International Classification of Dieases, 10th Edition). Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), Pregnancy Pressure Scale (PPS), Perceived physical discomfort level and number, Epworth Sleepiness Scale (ESS), and a general socio-demographic questionnaire were administered. Results: The results showed that about 20% of the pregnant women met the strict diagnosis criteria of insomnia. Independent-samples t-test revealed that several risk factors were correlated with the group with insomnia (N = 84) compared to the group without insomnia (N = 352). Binary Logistic regression analysis found that more significant bed partner influence (OR = 1.92, 95% CI: 1.03–۳٫۶۰), depressive symptoms (OR = 1.07, 95% CI: 1.00–۱٫۱۴), daytime sleepiness (OR = 1.07, 95% CI: 1.01–۱٫۱۴), subjective somatic discomfort (OR = 2.27, 95% CI: 1.11–۴٫۶۵), kinds of somatic discomfort (OR = 1.14, 95% CI: 1.03–۱٫۲۷) and later gestation (OR = 1.05, 95% CI: 1.01–۱٫۰۹) were significantly associated with insomnia. Conclusion: In this cohort of Chinese pregnant women, about a fifth of women suffered from clinically significant insomnia. Measures to prevent the adverse effects of insomnia should be provided to pregnant women with depressive symptoms, Sleep disturbance of the bed partner, excessive daytime sleepiness and somatic discomfort, especially late in gestation.
Introduction
Insomnia is the most prevalent sleep disturbance experienced in women during pregnancy, affecting 52%–۶۱% of pregnant women [1]. The prevalence of insomnia during pregnancy is high from the start and two thirds of pregnant women suffer from insomnia in the later period of pregnancy [2]. One previous study found that 97% of the women at the end of pregnancy reported middle-of-the-night awakenings, but only less than a third of the women considered sleep disruption as a problem [3]. It has been shown that insomnia is related to a number of potential maternal and infant health risks, such as adverse pregnancy outcomes (hypertension, gestational diabetes mellitus (GDM)) [4–۷]. Disturbed sleep in early and late pregnancy may also augment the risk for cardio-metabolic risk factors, which is associated with maternal and infant morbidity [4]. In addition, insomnia is frequently related to a variety of psychiatric disorders, such as depression and anxiety during pregnancy [8,9] and during the postpartum period [9–۱۱]. Insomnia symptoms are also related to BMI increase in post-pregnancy [12]. In addition, sleep loss during pregnancy is related to fetal intrauterine growth retardation, longer duration of delivery, and unplanned cesarean section [13,14]. Pregnant women who slept b6 h per night appear to have longer labor and 4.5 times higher likelihood of a cesarean section [13,15,16].