Association of Adverse Pregnancy Outcomes With Self-Reported Measures of Sleep Duration and Timing in Women Who Are Nulliparous

Abstract

Study Objectives: To examine the relationship of self-reported sleep during pregnancy with adverse pregnancy outcomes. A secondary objective was to describe the concordance between self-reported and objectively assessed sleep during pregnancy. Methods: In this prospective cohort, women completed a survey of sleep patterns at 6 to 13 weeks' gestation (visit 1) and again at 22 to 29 weeks' gestation (visit 3). Additionally, at 16 to 21 weeks (visit 2), a subgroup completed a week-long sleep diary coincident with an actigraphy recording. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration < 7 hours was defined as "short," and sleep midpoint after 5:00 am was defined as "late." The relationship of these sleep abnormalities with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) was determined. Results: Of the 10,038 women enrolled, sleep survey data were available for 7,524 women at visit 1 and 7,668 women at visit 3. A total of 752 women also provided ≥ 5 days of sleep diary data coincident with actigraphy at visit 2. We did not observe any consistent relationship between self-reported short sleep and HDP or GDM. There was an association between self-reported late sleep midpoint and GDM (visit 1 adjusted odds ratio 1.67, 95% confidence interval 1.17, 2.38; visit 2 adjusted odds ratio 1.73, 95% confidence interval 1.23, 2.43). At visit 2, 77.1% of participants had concordance between their diary and actigraphy for short sleep duration, whereas 94.3% were concordant for sleep midpoint. Conclusions: Self-reported sleep midpoint, which is more accurate than self-reported sleep duration, is associated with the risk of GDM.

Data-Driven Modeling of Pregnancy-Related Complications

“…The use of sensors and actigraphy to monitor sleep quality, activity patterns, and movement in patients is a novel approach to the quantification of lifestyle-related behaviors that might affect health [135,136]. Although this strategy has been underexplored, altered sleep patterns during pregnancy have been shown to lead to differential gene expression in mothers [137].…”

Sleep complaints in early pregnancy. A cross-sectional study among women attending prenatal care in general practice

“…We assessed sleep complaints by means of questions to the pregnant women. Such subjective measures of sleep duration and sleep efficiency have previously been shown to be correlated with objective measures [10,21], but may obviously be affected by the individual's reporting style. The degree of trouble and the level of worries can, however, only be assessed by the women themselves.…”

“…The mechanisms behind are unclear, but sleep disturbances may produce changes in the hypothalamic-pituitaryadrenal axis and abnormal immune/inflammatory reactions [7]. Further, sleep is critical for glucose metabolism and several meta-analyses found that both self-reported and objectively measured sleep is assoiated with hyperglycemia and an increased risk of gestational diabetes mellitus (GDM) [8][9][10]. Sleep is also important for blood pressure; both short and long sleep duration as well as poor sleep quality are associated with elevated blood pressure [11], measured with Pittsburgh Sleep Quality Index (PSQI) [12].…”

Gebelikte Uyku Sorunlarının Perinatal Süreçteki Etkileri ve Çözüm Sürecinde Hemşirelik Yaklaşımları

“…Gebelikte görülen uyku sorunları gebelikte aşırı kilo alımı, yaşam kalitesinin düşmesi, doğum sonrası ruh halinin kötüleşmesi, gestasyonel diyabetes mellitus ve yüksek arteryal kan basıncı gibi riskli durumların ortaya çıkmasını tetikleyebilmektedir (6,25,32,37,38). Gebelikte yaşanan uyku sorunlarının fetüs sağlığına da düşük doğum ağırlığı ve düşük apgar skoru gibi olumsuz etkileri bulunmaktadır (29,39).…”

“…Bir çalışmada, gebelerin gece saat 05'ten sonra uyumasının gestasyonel diyabetes mellitus riski ile ilişkili olduğu bulunmuştur. Bunun sebebinin biyolojik nedenli olabileceği, uyku zamanlamasının bozulmasının geceleri yapay ışığa maruz kalınarak melatonin salgılanmasını baskılayabileceği ve kronik bozulmaya yol açabileceği belirtilmiştir (37). Kuzey Tayvan'da gebe kadınlarla yapılan bir çalışmada; horlamanın, yüksek diyastolik kan basıncının ve yüksek ortalama arteriyel kan basıncının anlamlı bir belirleyicisi olduğu bulunmuştur.…”