Les troubles du sommeil pendant la grossesse et pendant le post-partum (revue de la littérature)

Abstract

Introduction and objectivesSleep disorders commonly occur in pregnancy and during post-partum. The aim of our study is to investigate the physiopathology of these disturbances and their putative role in the psychopathology of pregnant and puerperal women, in particular analysing their relationship with mood disorders. MethodsTrough a revision of relevant literature, we reported the most significant evidence regarding the relationship between sleep disorders and psychopathology in pregnancy and post-partum. ResultsPregnancy modifies sleeping both qualitatively and quantitatively. Sleep disorders are evolutionary, frequently reported during perinatal period and associated with the hormones variations of pregnancy. Pregnant women complained of a low sleep quality. Endocrine origin was the most frequent cause in the first quarter of pregnancy. While during the third quarter, the sleep disturbance was associated to physical concerns related to the body's modification (such as : abdominal growth, gastric burns, muscle cramps, urgency urinary and polyuria. The dreams, nightmares are more frequents in pregnancy period, the mechanisms of the increase of dreams is unclear, the hormonal and physical modifications during pregnancy as well as the psychological processes of becoming a mother seem to play a role. The unpleasant dreams and nightmares increase the distress and damage the quality of sleep Impact of sleeping disorder on the mood of pregnant women varies from irritability to depression. Their relation with characterized depressive episode remains difficult to estimate. Let us note the association between a poor sleep and an arisen of a likely depression. (The bad quality of the sleep precedes the appearance of a depressive signs). The prenatal stress participates in the insomnias. Moreover, lack of sleep, in the last days of pregnancy is associated with a longer work, one felt painful increased, and a difficult delivery. A spontaneous release of the premature work was also noticed. Finally it can favour the rise of one intense baby blues this a risk factor of evolution towards a maternal depression. Sleeping repair during post-partum is difficult because of the rough hormonal modifications, baby blues, the feeding and the rhythm of the baby. The quantitative lack sleep is accompanied with tiredness, diurnal slumber, and difficulties to concentrate, what increases the painful real-life experience of its disturbances. Unfortunately the exploration of sleeping disorders is difficult and the realization of randomized studies turns out to be challenging. The coverage of sleeping disorders during the pregnancy remains complex and difficult. The etiological factors of these disturbances are multiple, which limits the efficiency of the therapeutic answer besides the difficulties to the medicinal prescription. A premature intervention allows to warn the psychiatric complications at the mother and to protect the interactions mother-baby. ConclusionSleeping disorders are underestimated in the follow-up of pregnant women, they must be looked for and taken care of when they are invalidating to warn the arisen of the disorders of the mood and their consequences on the link between mother-child.