Abstract
BackgroundThe importance of maternal sleep and its contribution to maternal and fetal health during pregnancy is increasingly being recognised. However, the ability to accurately recall sleep practices during pregnancy has been questioned. The aim of this study is to test the accuracy of recall of normal sleep practices in late pregnancy.MethodsThirty healthy women between 35 and 38 weeks of gestation underwent level III respiratory polysomnography (PSG) with infrared digital video recordings in their own homes. Data regarding sleep positions, number of times getting out of bed during the night and respiratory measures were collected. A sleep questionnaire was administered the morning after the recorded sleep. Continuous data were assessed using Spearman’s Rho and Bland-Altman. Cohen’s Kappa was used to assess recall in the categorical variables.ResultsTwo-thirds of participants went to sleep on their left side. There was good agreement in sleep onset position between video and questionnaire data (Kappa 0.52), however the there was poor agreement on position on wakening (Kappa 0.24). The number of times getting out of bed during the night was accurately recalled (Kappa 0.65). Twenty five out of 30 participants snored as recorded by PSG. Questionnaire data was inaccurate for this measure. Bland-Altman plots demonstrated acceptable agreement between video and questionnaire data for estimated sleep duration, but not the time taken to fall asleep (sleep latency). One participant had mild obstructive sleep apnoea and another probable high upper airways resistance.ConclusionsSleep onset position, sleep duration and the number of times getting out of bed during the night were accurately recalled, but sleep latency and sleep position on waking were not. This study identifies the sleep variables that can be accurately obtained by questionnaire and those that cannot.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0905-0) contains supplementary material, which is available to authorized users.
Highlights
The importance of maternal sleep and its contribution to maternal and fetal health during pregnancy is increasingly being recognised
The importance of maternal sleep in late pregnancy (>28 weeks), in particular sleep position, with respect to stillbirth risk was identified by The Auckland Stillbirth Study [1] and has been confirmed by two subsequent studies [2, 3]
The participants were told the purpose of the study was to describe normal sleep in healthy pregnancy and were not informed that a purpose of the study was to assess the accuracy of their responses, so as not to influence their awareness of sleep, how they might sleep, and their questionnaire responses
Summary
The importance of maternal sleep and its contribution to maternal and fetal health during pregnancy is increasingly being recognised. The aim of this study is to test the accuracy of recall of normal sleep practices in late pregnancy. The majority of pregnant women settled to sleep in lateral positions, predominantly left lateral (77 %), with only 2 % supine. McIntyre et al BMC Pregnancy and Childbirth (2016) 16:115 controls’ sleep onset positions were more evenly spread amongst the left (26 %), right (32 %) and supine (38 %) positions. O’Brien and Warland [8] reported the typical night time sleep positions and duration of position adopted by 51 pregnant women (7–38 weeks gestation, mean 28.3 ± 6.9 weeks) using level III respiratory polysomnography (PSG) sleep studies. The duration spent in each position, sleep onset and awakening positions, and the accuracy of the women’s recall were not reported
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