Insomnia and potential risk factors during pregnancy

Abstract

Background: Insomnia during pregnancy adversely affects both mother and newborn, but evidence for its proportion and potential risk factors in Sri Lankan pregnant women is limited. Therefore, this study aimed to determine the proportion and factors associated with insomnia during pregnancy.Methods: A descriptive cross-sectional study was conducted among 404 antenatal women who participated in pregnancysupport groups on Facebook during the COVID-19 pandemic. They responded to a self-administered questionnaire that included the Insomnia Severity Index (ISI) to detect insomnia and questions adapted from the Stanford Sleep Questionnaire and an abbreviated version of the Penn State Worry Questionnaire to determine associated factors. Habitual sleep efficiency was calculated using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to determine the associations of risk factors with insomnia.Results: The proportion of insomnia overall was 32.7%, with proportions of moderate and severe insomnia being 28% and 1.5%, respectively. The proportion of insomnia was lowest in the 1st trimester (19.2%) and highest in the 3rd trimester (42.8%). The risk factors that were associated with insomnia included age ≥30 years (OR = 1.6, 95% CI 1.09-2.52), third trimester (OR = 3.1, 95% CI 1.49-6.56), overweight or obesity in early pregnancy (OR = 1.8, 95% CI 1.04-3.16), irregular sleep routine (OR = 5.2, 95% CI 3.28-8.42), sleeping on lateral position (OR = 1.6, 95% CI 1.03-2.71), trait of worry (OR = 2.4, 95% CI 1.50-4.02), night back pain (OR = 1.7, 95% CI 1.01-2.91), difficulty in breathing (OR = 2.4, 95% CI 1.37-4.39), heart burn and regurgitation (OR = 1.9, 95% CI 1.24-2.99), and awakening due to foetal movements (OR = 1.8, 95% CI 1.14-2.96).Conclusion: Insomnia during pregnancy was high and may have clinical implications for primary antenatal care practice. Many factors associated with insomnia during pregnancy are modifiable and can form the basis for prevention and management.