Objective-To evaluate the feasibility and efficacy of a home-based cognitive-behavioral training program for sleep during late pregnancy.Methods-A nonrandomized quasi-experimental sample of nulliparous women who received the intervention during pregnancy (n=25) was compared to two control groups (n=76 and n=48) from other intervention studies at similar postintervention time points: approximately 1 month before childbirth and 1-2 months after childbirth. The home-based Sleep Enhancement Training System for Pregnancy consisted of 4 weeks of sound-enhanced audio relaxation programs, readings, and daily sleep diaries. Both control groups received dietary recommendations for improving sleep. Sleep duration (total sleep time) and sleep disruption (wake after sleep onset) were measured using wrist actigraphy for a minimum of 48 hours on consecutive weekdays.Results-The intervention group had significantly longer sleep duration and less sleep disruption than both control groups, particularly at the postpartum assessment. Intervention participants slept an average of 430 (95% confidence interval [CI] 397-464) minutes during pregnancy, compared to 420 (95% CI 403-438) and 417 (95% CI 395-439) minutes for the two control groups. At the postpartum assessment, the intervention group slept 446 (95% CI 415-478) minutes compared to 390 (95% CI 373-408) and 370 (95% CI 348-393) minutes for controls. In terms of sleep disruption, the intervention group had 16.1% (95% CI 11.9-20.2%) wake after sleep onset during pregnancy, while controls had 13.4% (95% CI 11.2-15.5%) and 20.4% (95% CI 17.7-23.0%). Postpartum, the intervention group had 20.3% (95% CI 16.4-24.1%) wake after sleep onset compared to 26.6% (95% CI 24.5-28.8%) and 28.7% (95% CI 26.0-31.5%) among control. Participant feedback about the intervention was generally positive, although intervention adherence was variable.Conclusions-This study provides evidence of the feasibility and efficacy of the Sleep Enhancement Training System for Pregnancy intervention for enhancing sleep that typically worsens during late pregnancy and after childbirth. PrécisA cognitive-behavioral intervention that includes relaxation training demonstrates feasibility and efficacy for minimizing sleep disruption among women in late pregnancy and after childbirth.
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