Nocturnal Lifestyle Behaviours and Risk of Poor Sleep during Pregnancy

Abstract

The extent to which lifestyle practices at night influence sleep quality in pregnant women remains unknown. This study aimed to examine whether nocturnal behaviours were associated with poor sleep during pregnancy. We performed a cross-sectional analysis of a prospective cohort of pregnant women at 18–24 gestation weeks recruited from KK Women’s and Children’s Hospital, Singapore, between 2019 and 2021. Nocturnal behaviours were assessed with questionnaires, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) with a global score ≥5 indicative of poor sleep quality. Modified Poisson regression and linear regression were used to examine the association between nocturnal behaviour and sleep quality. Of 299 women, 117 (39.1%) experienced poor sleep. In the covariate-adjusted analysis, poor sleep was observed in women with nocturnal eating (risk ratio 1.51; 95% confidence interval [CI] 1.12, 2.04) and nocturnal artificial light exposure (1.63; 1.24, 2.13). Similarly, nocturnal eating (β 0.68; 95% CI 0.03, 1.32) and light exposure (1.99; 1.04, 2.94) were associated with higher PSQI score. Nocturnal physical activity and screen viewing before bedtime were not associated with sleep quality. In conclusion, reducing nocturnal eating and light exposure at night could potentially improve sleep in pregnancy.

Chrononutrition during Pregnancy and Its Association with Maternal and Offspring Outcomes: A Systematic Review and Meta-Analysis of Ramadan and Non-Ramadan Studies

“…However, further adjustment for negative emotions, lifestyle behaviors, maternal age, etc. attenuated the association between night eating and sleep quality ( β = 0.36, 95% CI: −0.24, 0.97) [ 29 ].…”

“…Regression coefficient: beta estimates ( β ); hemoglobin A1c (HbA1c); high density lipoprotein (HDL) cholesterol; homeostasis model assessment for insulin resistance (HOMA-IR); odds ratio (OR); predominantly daytime (pDT); postpartum weight retention (PPWR); relative risk (RR). Due to a different approach used, the study by Messika et al was not included in the figure; please refer to main text for the results [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

“…In human, endogenous melatonin levels start to increase approximately 2 h before natural sleep onset and peak approximately 5 h later [ 81 ]. Since eating at night can lead to a decrease in melatonin secretion [ 82 ], it can result in poor sleep quality [ 28 , 29 ]. During pregnancy, the peak of maternal melatonin levels gradually increase approximately four-fold from 24 weeks of gestation to term [ 83 ].…”

Development, validation, and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P)

“…Despite the growing interest in the field of chrononutrition, there is a lack of standardized questionnaires specifically designed to capture meal timing data and its relationship with pregnancy-related variables. Most studies use a diet record and sleep questionnaire to capture meal and sleep timings during pregnancy [9,19]. This may reduce the compliance rate as the questionnaires are lengthy and may require trained interviewers to capture the accurate data.…”