Associations Of Sleep, Physical Activity, And Sedentary Behavior Across Pregnancy Trimesters

Abstract

PURPOSE: Sleep and physical activity are altered in pregnancy and may affect pregnancy health; however, whether these behaviors influence each other is not well understood. In this study, we describe self-reported sleep parameters across pregnancy trimesters and examine associations with objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB). METHODS: Women were recruited from Iowa City, IA and Pittsburgh, PA to assess sleep, MVPA, and SB in each trimester of pregnancy. Sleep was measured using the Pittsburgh Sleep Quality Index. MVPA and SB were estimated using a waist-worn ActiGraph GT3X and thigh-worn activPAL3 micro, respectively; data were considered valid with ≥4 days of ≥10 hours of wear. Mixed effects models were used to examine changes in sleep parameters (global sleep score, poor sleep quality, sleep efficiency, sleep duration) across trimesters. Associations of MVPA and SB trajectories with sleep parameters were also examined using mixed effects models. RESULTS: Women (n=120) averaged 31.1 ± 4.7 years of age with a pre-pregnancy BMI of 26.8 ± 6.7 kg/m2. As seen in the Table, differences were found for all sleep parameters across pregnancy trimesters, with adverse changes occurring in the third trimester compared to the first and second trimesters. MVPA trajectory was not associated with any of the sleep parameters. Women in the high SB trajectory had greater sleep efficiency (β=4.78%, 95% CI: 0.07, 9.49) and women in the moderate and high SB trajectories also had longer sleep duration (β=0.79 hours, 95% CI: 0.23, 1.35; β=0.80 hours, 95% CI: 0.26, 1.33, respectively), compared to those in the low SB trajectory. CONCLUSIONS: Few studies have examined self-reported sleep measures across pregnancy trimesters. Findings indicate that sleep quality, efficiency, and duration are adversely affected in the third trimester. Contrary to our hypotheses, high SB but not MVPA was favorably associated with sleep parameters.