Abstract
BackgroundPregnancy associated sleep disturbances is a common pregnancy-related complication which can lead to significant maternal distress and adverse pregnancy outcomes. Sleep quality can be affected by multiple factors and obesity has been recognized as one of them. Various previous studies have demonstrated poorer sleep quality during pregnancy. However, most studies included assessment at only one point of pregnancy. This prospective cohort study aimed to better evaluate the effect of pregnancy on the quality of sleep throughout the antenatal period and how BMI affects antenatal sleep.MethodsA total of 926 women were recruited before 14 weeks of gestation and followed throughout pregnancy. The Pittsburgh Sleep Quality Index questionnaire (PSQI) was employed to assess sleep quality in 4 antenatal visits throughout pregnancy. Their weight was also recorded at each visit.ResultsThe PSQI global score was higher towards the later part of pregnancy (6.4 to 8.0, p < 0.001) and highest at the 4th visit. Sleep latency was longer as pregnancy progressed (18.5 mins to 23.2 mins, p = 0.001). Sleep duration became shorter over time and was the shortest at the 4th visit (7.1 h to 6.5 h, p < 0.001). Sleep efficiency was the lowest at the 4th visit (85.2 to 81.6%, p < 0.001). The same trend was observed for subjects in different BMI groups throughput pregnancy. PSQI score increased and sleep duration decreased as BMI increased. The effect of increasing BMI on PSQI and sleep duration was only observed in the higher BMI groups (> 25 kg/m2).ConclusionsOur study showed that sleep quality gradually declined throughout pregnancy for all BMI groups. Higher BMI was associated with poorer sleep as represented by PSQI score and sleep duration, particularly in the overweight and obese subgroups.
Highlights
Pregnancy associated sleep disturbances is a common pregnancy-related complication which can lead to significant maternal distress and adverse pregnancy outcomes
Poorer sleep efficiency, insomnia and overall poor sleep quality characterize the sleep of antenatal women, especially in late pregnancy [5,6,7,8]
Our prospective study aimed to assess the change of sleep quality in detail as pregnancy progresses
Summary
Pregnancy associated sleep disturbances is a common pregnancy-related complication which can lead to significant maternal distress and adverse pregnancy outcomes. Most studies included assessment at only one point of pregnancy This prospective cohort study aimed to better evaluate the effect of pregnancy on the quality of sleep throughout the antenatal period and how BMI affects antenatal sleep. Our prospective study aimed to assess the change of sleep quality in detail (overall sleep quality, sleep duration, sleep efficiency and sleep latency) as pregnancy progresses. As obesity is increasingly prevalent globally and associated with sleep disorders such as sleep apnea and cause sleep disturbances in both non-pregnant and pregnant population [21,22,23], it is interesting to explore sleep quality in women in different body mass index (BMI) groups. One large cohort study involving 2366 pregnant women by Guinhouya BC et al showed overall sleep quality was worst in 3rd trimester and obese women exhibit a greater PSQI score than women with normal weight [24]. Our study aimed to provide a comprehensive comparison on various aspects of sleep through pregnancy among women in different BMI categories
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