Elsevier

Sleep Medicine

Volume 16, Issue 4, April 2015, Pages 483-488
Sleep Medicine

Original Article
Sleep patterns and sleep disturbances across pregnancy

https://doi.org/10.1016/j.sleep.2014.12.006Get rights and content

Highlights

  • Women experience significant sleep disruption and inadequate sleep throughout pregnancy.

  • There are no differences across the month of pregnancy for insomnia, daytime sleepiness, or fatigue.

  • Frequent urination and difficulty finding a comfortable position frequently disturb sleep.

  • All women should be screened and treated for sleep disturbances throughout pregnancy.

Abstract

Objective

This study sought to characterize sleep patterns and sleep problems in a large sample of women across all months of pregnancy.

Methods

A total of 2427 women completed an Internet-based survey that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, vitality scale of the Short Form 36 Health Survey (SF-36), Insomnia Severity Index (ISI), Berlin questionnaire, International Restless Legs Syndrome (IRLS) question set, and a short version of the Pregnancy Symptoms Inventory (PSI).

Results

Across all months of pregnancy, women experienced poor sleep quality (76%), insufficient nighttime sleep (38%), and significant daytime sleepiness (49%). All women reported frequent nighttime awakenings (100%), and most women took daytime naps (78%). Symptoms of insomnia (57%), sleep-disordered breathing (19%), and restless legs syndrome (24%) were commonly endorsed, with no difference across the month of pregnancy for insomnia, sleep-disorder breathing, daytime sleepiness, or fatigue. In addition, high rates of pregnancy-related symptoms were found to disturb sleep, especially frequent urination (83%) and difficulty finding a comfortable sleep position (79%).

Conclusions

Women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout pregnancy. These results suggest that all women should be screened and treated for sleep disturbances throughout pregnancy, especially given the impact of inadequate sleep and sleep disorders on fetal, pregnancy, and postpartum outcomes.

Section snippets

Participants

Participants included 2427 pregnant women: at recruitment, < 2 months (n = 346), three months (n = 298), four months (n = 282), five months (n = 269), six months (n = 265), seven months (n = 354), and ≥8 months (n = 613).

Procedure

All data were collected online. The questionnaire was set as a pop-up screen on BabyCenter, a popular pregnancy website. Completion of the questionnaire was voluntary, there were no exclusionary criteria, and the study was approved by the Institutional Review Board of Saint

Demographics

Complete demographic data for the entire sample are provided in Table 1. Most women were between the ages of 25 and 34 years (63.1%) and Caucasian (56.2%). Approximately half had a college education (57.8%) and half were employed full time (51.5%). The sample was almost evenly split between those with household incomes under $50,000 (41.9%) and those over (58.1%). Approximately half (51.8%) of the participants were multiparous. No significant differences were noted across month of pregnancy for

Comments

To the best of our knowledge, this study is the first large-scale survey of sleep during pregnancy that looked at data month by month. Across pregnancy, women experienced poor sleep quality, insufficient nighttime sleep, significantly disrupted sleep, and significant daytime sleepiness. Overall, 76% of the women were found to be poor sleepers, as assessed by the PSQI [9]. This rate of poor sleep is much higher than for women in the general population. For example, in a global study of women

Funding sources

This study was supported by Johnson & Johnson Consumer & Personal Products Worldwide, a division of Johnson & Johnson Consumer Companies, Inc. The sponsor was involved in data collection. Dr. Mindell took sole responsibility for data analysis, interpretation of the data, writing of the report, and in the decision to submit the article for publication.

Conflict of interest

Jodi Mindell has served as a consultant and speaker for Johnson & Johnson. Rae Ann Cook and Janeta Nikolovski are employees of Johnson & Johnson.

The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2014.12.006.

. ICMJE Form for Disclosure of Potential Conflicts of Interest form.

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