Abstract
BackgroundFrequently observed sleep/wake problems among pregnant women need comprehensive evaluation. This study was conducted to clarify the sleep/wake problems among pregnant women without gestational complications during the second and third trimester and the effects of sleep/wake problems on delivery outcomes.MethodsA total of 88 Japanese pregnant women participated in this study. In their second and third trimester, subjective sleep quality, insomnia severity, excessive daytime sleepiness (EDS), and restless legs syndrome/Willis-Ekbom disease (RLS/WED) were assessed using questionnaires; also, sleep disordered breathing (SDB) was screened using a pulse oximeter.ResultsFrom the second to the third trimester, an increasing tendency of sleep/wake problems was observed. During the third trimester, the percentages of women experiencing decreased subjective sleep quality, difficulty maintaining sleep (DMS), EDS, RLS/WED, and 3% oxygen desaturation index (ODI) values ≥5/h were 62.5, 45.5, 48.9, 9.1, and 29.5%, respectively. In a logistic regression analysis for EDS in the third trimester, the adjusted odds ratio (95% confidence interval) of total sleep duration < 6 h, moderate to severe DMS, and 3% ODI values ≥5/h were 3.25 (1.16–9.10), 4.74 (1.60–14.00), and 0.90 (0.28–2.89), respectively. Although short sleep durations, decreased subjective sleep quality, EDS, and SDB did not affect delivery outcomes or the infant’s condition, the percentage of women undergoing cesarean sections in the severe insomnia group was significantly higher (p = 0.008).ConclusionsSleep/wake problems were frequent during pregnancy, especially during the third trimester. EDS among pregnant women was associated with shorter sleep durations and DMS rather than SDB. The effect of factors related to insomnia on delivery outcomes should thus be considered a crucial problem among pregnant Japanese women without gestational complications in clinical practice.
Highlights
Observed sleep/wake problems among pregnant women need comprehensive evaluation
The data were collected at 24.6 ± 0.6 weeks of gestation in the second trimester and 36.2 ± 0.9 weeks of gestation in the third trimester (Additional file 1)
More than 90% of women had difficulty initiating sleep (DIS) and/or difficulty maintaining sleep (DMS) during the third trimester and the percentage of women with moderate to severe DIS and/or DMS increased from 31.8% in the second trimester to 55.7% in the third trimester (p < 0.001)
Summary
Observed sleep/wake problems among pregnant women need comprehensive evaluation. SDB, RLS/ WED, shorter or longer sleep durations, poor sleep quality, and EDS have been reported to be associated with gestational diabetes and hypertensive disorders during pregnancy [6, 8,9,10,11,12]. These maternal sleep/wake problems affect cesarean delivery, preterm birth rates, rates of children born small- and large-for-gestational-age, and admission rates to the neonatal intensive care unit [6, 8, 11,12,13,14]. Mutual interactions among different types of sleep/wake problems cannot be ignored
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