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Sarvaran K, Abbasalizadeh F, Alaei M, Fathnezhad-Kazemi A. Prevalence of Sleep Disorders and the Effect of Sleep Health Education on Sleep Quality in Pregnant Women With Sleep Disorders. Am J Lifestyle Med 2024; 18:435-444. [PMID: 38737882 PMCID: PMC11082865 DOI: 10.1177/15598276231178746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Objective Sleep quality affects pregnant women's health and quality of life. The aims of the study were to investigate the prevalence of sleep disorders and the effect of sleep health education on sleep quality in pregnant women with sleep disorders. Methods To examine the frequency of sleep disorders among pregnant women, a cross-sectional study was conducted with an initial enrollment of 370 participants. Subsequently, 162 pregnant women were recruited for a pretest-posttest quasi-experimental design study. The intervention group (n = 82) performed sleep health education for four weeks and the control group (n = 80) received standard care. Sleep quality was assessed with Pittsburgh Sleep Quality. Results The prevalence of sleep disorder was 61.9 percent (CI 95% 56.85-66.69). It was determined that health education improved some sleep quality subscales including subjective sleep quality, sleep latency, sleep duration and habitual sleep efficiency, and sleep disturbances, daytime dysfunction, and global sleep quality. The difference was still significant after adjusting for the PSQI baseline (η2 = .311, P < .001). Conclusion These findings provide evidence of a relatively high prevalence of sleep disorders in pregnancy. Therefore, screening for sleep disorders and providing supportive programs and models to improve sleep quality during pregnancy should be considered as part of prenatal care.
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Affiliation(s)
- Kosar Sarvaran
- Students’ Research committee,
Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Fatemeh Abbasalizadeh
- Women’s reproductive health
research center, Tabriz University of Medical
Sciences, Tabriz, Iran
| | - Maede Alaei
- Students’ Research committee,
Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Azita Fathnezhad-Kazemi
- Department of Midwifery, Women’s
Reproductive and Mental Health Research center, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
- Department of Midwifery, Faculty of
Nursing and Midwifery, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
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2
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Li Y, Liang C, Wu C, Nan Z. Association between sleep duration during pregnancy and gestational diabetes mellitus: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1337492. [PMID: 38737761 PMCID: PMC11082293 DOI: 10.3389/fmed.2024.1337492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/15/2024] [Indexed: 05/14/2024] Open
Abstract
Objective To systematically review studies on the correlation between sleep duration during pregnancy and gestational diabetes mellitus (GDM) and use meta-analysis to explore the correlation between the two to provide a basis for preventing GDM during pregnancy. Methods The search databases were China Knowledge Network (CNKI), Weipu, Wanfang, China Biomedical Literature Service System (SinoMed), Cochrane Library, Web of Science, Embase, and PubMed, and the search time was from the establishment of the above databases to July 2023. The data were statistically analyzed using STATA/MP17 and RevMan 5.3 software. Publication bias could be accurately assessed using funnel plots and Egger's test. Results A total of 5,197 papers were searched, and 13 studies were finally included, which included 80,259 individuals, including 3,461 patients with GDM. The comprehensive analysis showed that. Based on pooled data from prospective, cross-sectional, and case-control studies, extreme sleep duration during pregnancy was strongly associated with GDM compared with average sleep duration. The results of the prospective studies showed that both short (OR = 1.50, 95% CI: 1.07-2.10, I2 = 60.9%, p = 0.02) and long (OR = 1.28, 95% CI: 1.13-1.46, I2 = 0.0%, p < 0.0001) sleep duration increased the risk of gestational diabetes mellitus, but the harms were more pronounced with short sleep. In analyzing the association between extreme sleep duration and GDM, publication bias was found in prospective, cross-sectional, and case-control studies with moderate heterogeneity and prospective-only studies with low heterogeneity. Conclusion Both too short and too long sleep duration during pregnancy are strongly associated with GDM. Either too short or too long sleep duration predicts the risk of developing GDM, but the harms are more pronounced with short sleep. These findings remind us of the importance of controlling sleep duration during pregnancy and help to optimize early strategies to prevent GDM.Systematic review registration: http://www.crd.york.ac.uk/prospero, identifier [CRD42023470925].
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Affiliation(s)
- Yuandong Li
- Changchun University of Chinese Medicine, Changchun, China
| | - Chao Liang
- Changchun University of Chinese Medicine, Changchun, China
| | - Cui Wu
- Changchun University of Chinese Medicine, Changchun, China
| | - Zheng Nan
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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3
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Lamichhane DK, Ha E, Hong YC, Lee DW, Park MS, Song S, Kim S, Kim WJ, Bae J, Kim HC. Ambient particulate matter and surrounding greenness in relation to sleep quality among pregnant women: A nationwide cohort study. Heliyon 2024; 10:e26742. [PMID: 38434397 PMCID: PMC10904245 DOI: 10.1016/j.heliyon.2024.e26742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Particulate air pollution and residential greenness are associated with sleep quality in the general population; however, their influence on maternal sleep quality during pregnancy has not been assessed. Objective This cross-sectional study investigated the individual and interactive effects of exposure to particulate matter (PM) air pollution and residential greenness on sleep quality in pregnant women. Methods Pregnant women (n = 4933) enrolled in the Korean Children's Environmental Health Study with sleep quality information and residential address were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The average concentrations of PM (PM2.5 and PM10) during pregnancy were estimated through land use regression, and residential greenness in a 1000 m buffer area around participants' residences was estimated using the Normalized Difference Vegetation Index (NDVI1000-m). Modified Poisson regression models were used to estimate the associations between PM and NDVI and poor sleep quality (PSQI >5) after controlling for a range of covariates. A four-way mediation analysis was conducted to examine the mediating effects of PM. Results After adjusting for confounders, each 10 μg/m3 increase in PM2.5 and PM10 exposure was associated with a higher risk of poor sleep quality (relative risk [RR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11; and RR: 1.09; 95% CI: 1.06, 1.13, respectively), and each 0.1-unit increase in NDVI1000-m was associated with a lower risk of poor sleep quality (RR: 0.97; 95% CI: 0.95, 0.99). Mediation analysis showed that PM mediated approximately 37%-56% of the association between residential greenness and poor sleep quality. Conclusions This study identified a positive association between residential greenness and sleep quality. Furthermore, these associations are mediated by a reduction in exposure to particulate air pollution and highlight the link between green areas, air pollution control, and human health.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Myung-Sook Park
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Sanghwan Song
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Suejin Kim
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
| | - Jisuk Bae
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Ko-CHENS Study Group
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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4
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Tsega SS, Kiflu M, Wubante SM, Mekonnen BD, Tarekegn YA. Sleep disturbance and its associated factors among pregnant women in Ethiopia: systematic review and meta-analysis. BMC Psychiatry 2024; 24:51. [PMID: 38225632 PMCID: PMC10789060 DOI: 10.1186/s12888-023-05456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION Globally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment, preterm birth, low birth weight, and neonatal morbidity and mortality. In Ethiopia, inconsistent findings have been reported on the prevalence of sleep disturbance among pregnant women. Therefore, this review aims to estimate the pooled prevalence sleep disturbance and its associated factors among pregnant women in Ethiopia. METHODS This systematic review and meta-analysis of observational studies was designed according to the PRISMA guideline. A systematic search of literature was conducted in PubMed, Scopus, Web of science, and Google Scholar using relevant searching key terms. The Newcastle-Ottawa scale was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A fixed-effects model was applied during meta-analysis. RESULTS In this review, six studies were included after reviewing 17,100 articles. The pooled prevalence of sleep disturbance among pregnant women in Ethiopia was 50.43% (95%CI: 39.34-61.52). Third trimester pregnancy AOR = 4.03; 95% CI: 2.84,5.71), multigravidity (AOR = 1.99; 95% CI: 1.54, 2.59), unplanned pregnancy (AOR = 2.56; 95% CI: 1.52,4.31), depression (AOR = 3.57; 95% CI: 2.04, 6.27), stress (AOR = 2.77; 95% CI: 1.57, 4.88), anxiety (AOR = 3.69; 95% CI: 1.42, 9.59) and poor sleep hygiene (AOR = 2.49; 95% CI: 1.56, 3.99) and were statistically associated with sleep disturbance among pregnant women. CONCLUSION This review revealed that the magnitude of sleep disturbance among pregnant woman in Ethiopia was relatively high and multiple factors determined the likelihood of having a disturbed sleep-awake pattern. Thus, the implementation of interventions for sleep disturbance after screening pregnant women is needed. Moreover, public health interventions targeted on the prevention of unintended pregnancy and depression during pregnancy should be implemented.
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Affiliation(s)
- Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Mekdes Kiflu
- Clinical pharmacy unit, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Sisay Maru Wubante
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | - Yeshambel Andargie Tarekegn
- Department of Otorhinolaryngology (ENT), School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Chen X, Liu Y, Liu M, Min F, Tong J, Wei W, Sun L, Zhang T, Meng Q. Prevalence and associated factors of insomnia symptoms among pregnant women in the third trimester in a moderately developing region of China. BMC Public Health 2023; 23:2319. [PMID: 37996812 PMCID: PMC10668519 DOI: 10.1186/s12889-023-17269-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Insomnia is the most common sleep disorder in the general population, especially among pregnant women, and it is considered a major public health issue. Not only can it cause mental and physical problems in pregnant women, but it may also affect the growth of the fetus. However, there are few reports on the prevalence and influencing factors of insomnia symptoms in third-trimester women in China. The objective of this study was to assess the prevalence of insomnia symptoms among pregnant women in the third trimester in a moderately developing region of China and to further explore the associated factors of insomnia symptoms from various aspects. METHODS A cross-sectional survey was conducted among eligible pregnant women in the third trimester from December 2022 to February 2023. Data on socio-demographic characteristics, clinical characteristics, and behavioral and psychological characteristics of pregnant women were collected through a structured questionnaire. The Chi-square test and multivariate logistics regression were applied to explore the associated factors of insomnia symptoms. RESULTS A total of 535 pregnant women in the third trimester were included in this study, and the prevalence of insomnia symptoms was 59.8%. Multivariate logistic regression analysis revealed that pregnant women who lived together with elders (OR: 0.58, 95% CI: 0.40-0.86), had low perceived stress (OR: 0.58, 95% CI: 0.35-0.97), had no threatened abortion (OR: 0.55, 95% CI: 0.32-0.93) and had good doctor-patient communication (OR: 0.66, 95% CI: 0.45-0.98) were more likely to stay away from insomnia symptoms. However, pregnant women with anxiety symptoms (OR: 2.27, 95% CI: 1.28-4.03), fear of childbirth (OR: 1.63, 95% CI: 1.11-2.40) and a high experience of COVID-19 fear (OR: 1.61, 95% CI: 1.03-2.54) tended to have insomnia symptoms. CONCLUSIONS The prevalence of insomnia symptoms in pregnant women is high in Lianyungang city in eastern China in the third trimester. Insomnia symptoms is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of insomnia symptoms in the third trimester and to focus on pregnant women with risk factors for insomnia symptoms.
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Affiliation(s)
- Xu Chen
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China
| | - Yuan Liu
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China
| | - Meilin Liu
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China
| | - Fanli Min
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China
| | - Jiao Tong
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China
| | - Wei Wei
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China
| | - Lizhou Sun
- First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Teng Zhang
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China.
| | - Qian Meng
- Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, Jiangsu, China.
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6
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Lugo-Candelas C, Hwei T, Lee S, Lucchini M, Smaniotto Aizza A, Kahn LG, Buss C, O'Connor TG, Ghassabian A, Padula AM, Aschner J, Deoni S, Margolis AE, Canino G, Monk C, Posner J, Duarte CS. Prenatal sleep health and risk of offspring ADHD symptomatology and associated phenotypes: a prospective analysis of timing and sex differences in the ECHO cohort. LANCET REGIONAL HEALTH. AMERICAS 2023; 27:100609. [PMID: 38106969 PMCID: PMC10725065 DOI: 10.1016/j.lana.2023.100609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 12/19/2023]
Abstract
Background Sleep difficulties are common in pregnancy, yet poor prenatal sleep may be related to negative long-term outcomes for the offspring, including risk for attention-deficit/hyperactivity disorder (ADHD). Existing studies are few and have not examined timing of exposure effects or offspring sex moderation. We thus aimed to test the hypotheses that poor sleep health in pregnancy is associated with increased risk for ADHD symptoms and offspring sleep problems at approximately 4 years of age. Methods Participants were 794 mother-child dyads enrolled in the NIH Environmental Influences on Child Health Outcomes Study (ECHO). Participants self-reported on sleep duration, quality, and disturbances during pregnancy and on children's ADHD symptoms and sleep problems on the Child Behaviour Checklist. Findings Pregnant participants were 32.30 ± 5.50 years and children were 46% female. 44 percent of pregnant participants identified as Hispanic or Latine; 49% identified as White. Second-trimester sleep duration was associated with offspring ADHD symptoms (b = -0.35 [95% CI = -0.57, -0.13], p = 0.026), such that shorter duration was associated with greater symptomatology. Poorer sleep quality in the second trimester was also associated with increased ADHD symptomatology (b = 0.66 [95% CI = 0.18, 1.14], p = 0.037). Greater sleep disturbances in the first trimester were associated with offspring ADHD (b = 1.03 [95% CI = 0.32, 1.03], p = 0.037) and in the second trimester with sleep problems (b = 1.53 [95% CI = 0.42, 2.92], p = 0.026). We did not document substantial offspring sex moderation. Interpretation Poor prenatal sleep health, particularly quality and duration in the second trimester, may be associated with offspring risk of neurodevelopmental disorders and sleep problems in early childhood. Further research is needed to understand mechanisms, yet our study suggests that prenatal maternal sleep may be a modifiable target for interventions aimed at optimizing early neurodevelopment. Funding NIH grants U2COD023375, U24OD023382, U24OD023319, UH3OD023320, UH3OD023305, UH3OD023349, UH3OD023313, UH3OD023272, UH3OD023328, UH3OD023290, K08MH117452 and NARSAD Young Investigator Award 28545.
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Affiliation(s)
- Claudia Lugo-Candelas
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Tse Hwei
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Seonjoo Lee
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | | | - Alice Smaniotto Aizza
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Linda G. Kahn
- NYU Grossman School of Medicine, 227 East 34th Street, Room 811, New York, NY, 10016, USA
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstrasse 57, 10117, Berlin, Germany
| | | | - Akhgar Ghassabian
- NYU Grossman School of Medicine, 227 East 34th Street, Room 811, New York, NY, 10016, USA
| | - Amy M. Padula
- University of California, San Francisco, 490 Illinois Street, Box 0132, San Francisco, CA, 94158, USA
| | - Judy Aschner
- Hackensack Meridian School of Medicine, Nutley NJ and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sean Deoni
- Bill & Melinda Gates Foundation, 500 Mercer Str, Seattle, WA, 98275, USA
| | - Amy E. Margolis
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Glorisa Canino
- University of Puerto Rico Medical Sciences Campus, Behavioral Sciences Research Institute, 9th Floor, Rio Piedras, PR, 00935, Puerto Rico
| | - Catherine Monk
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jonathan Posner
- Duke University, North Pavilion Building, 2400 Pratt Street, Durham, NC, 27705, USA
| | - Cristiane S. Duarte
- New York State Psychiatric Institute/Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
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7
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Ma S, Li P, Li D, Zhou M, Li L, Yin W, Wang P, Zhang Y, Zhu D, Zhu P. Increasing systemic chronic inflammation mediated the association between poor sleep during pregnancy and gestational cardiovascular health. Sleep Health 2023; 9:460-466. [PMID: 37088599 DOI: 10.1016/j.sleh.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/30/2022] [Accepted: 01/21/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES This study aimed to examine the association between sleep behaviors and cardiovascular health (CVH) during pregnancy and test whether high-sensitivity C-reactive protein (hs-CRP) mediates this association. METHODS The study included 4204 pregnant women from the Maternal and Infant Health cohort study in Hefei (MIH-Hefei). Information on sleep (chronotype, sleep duration, snoring, daytime sleepiness, and insomnia) was collected through a touch-screen structured questionnaire at 16-23 weeks' gestation. CVH (body mass index, blood pressure, total cholesterol, glucose, and smoking) and hs-CRP were measured at 24-28 weeks' gestation. The role of hs-CRP in the association between sleep and CVH was explored in a mediation analysis, while adjusting for multiple confounding factors. RESULTS Poor sleep score was significantly associated with poor gestational CVH metrics, including an RR of 0.872 (95% CI, 0.810, 0.938) for having all ideal (vs. any nonideal) CVH metrics; hs-CRP level was significantly associated with poor gestational CVH metrics, including an RR of 0.531 (95% CI, 0.432, 0.609) for having all ideal (vs. any nonideal) CVH metrics. Sleep scores were positively correlated with hs-CRP level (β, 0.020, 95% CI, 0.006, 0.034). Mediation analysis revealed that the association between sleep and CVH mediated by hs-CRP was 12.31% (indirect effect, -0.0095, 95% CI, -0.0167, -0.0042). CONCLUSIONS Poor sleep during pregnancy, particularly late chronotype and snoring, may worsen CVH by increasing systemic chronic inflammation.
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Affiliation(s)
- Shuangshuang Ma
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Fourth People's Hospital of Hefei, Hefei, Anhui, China; Anhui Mental Health Center, Hefei, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Pei Li
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Deqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Department of Nephrology, High-tech Zone, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Meiting Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Lei Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Wanjun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Yimo Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Daomin Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Fourth People's Hospital of Hefei, Hefei, Anhui, China; Anhui Mental Health Center, Hefei, Anhui, China.
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China.
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Chen X, Liu M, Min F, Tong J, Liu Y, Meng Q, Zhang T. Effect of biological, psychological, and social factors on maternal depressive symptoms in late pregnancy: a cross-sectional study. Front Psychiatry 2023; 14:1181132. [PMID: 37346902 PMCID: PMC10281506 DOI: 10.3389/fpsyt.2023.1181132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction Depression commonly occurs during pregnancy and has become a major public health concern. Depression not only affects the individual but also causes adverse consequences for families and children. However, little is known regarding the depression status and its influencing factors in women during late pregnancy in China. This study aimed to assess the prevalence of maternal depressive symptoms in late pregnancy during the coronavirus disease 2019 (COVID-19) pandemic and further explore the effect of biological, psychological, and social factors on depressive symptoms. Methods An institution-based cross-sectional survey was conducted among eligible women in the late pregnancy stage and underwent prenatal examination at Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China from December 2022 to February 2023. Data regarding depressive symptoms and biological, psychological, and social factors of the pregnant women were collected via a structured questionnaire. Chi-square test, Fisher's exact tests, and binary logistics regression were used to analyze the data. Results In total, 535 women in the late pregnancy stage were included in this study, 75 (14.0%) of whom exhibited depressive symptoms. A binary logistic regression analysis revealed that pregnant women who were multiparous (OR: 2.420, 95% CI: 1.188-4.932) and had moderate or severe insomnia symptoms (OR: 4.641, 95% CI: 1.787-12.057), anxiety (OR: 8.879, 95% CI: 4.387-17.971), high fear of COVID-19 (OR: 2.555, 95% CI: 1.255-5.199), moderate or severe family dysfunction (OR: 2.256, 95% CI: 1.141-4.461), and poor social support (OR: 2.580, 95% CI: 1.050-6.337) tended to show depressive symptoms. Conversely, pregnant women who received regular prenatal care (OR: 0.481, 95% CI: 0.243-0.951) and had good drinking water quality at home (OR: 0.493, 95% CI: 0.247-0.984) were more likely to avoid developing depressive symptoms. Conclusion This study found that the prevalence of maternal depressive symptoms during late pregnancy was high and had multiple influencing factors. Thus, screening for depressive symptoms in women in the late pregnancy stage and providing special intervention programs are necessary, especially for those with risk factors.
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Zheng X, Zhu Z, Chen J, He J, Zhu Y, Zhang L, Qu F. Efficacy of cognitive behavioural therapy for insomnia or sleep disturbance in pregnant women: A systematic review ad meta-analysis. J Sleep Res 2023; 32:e13808. [PMID: 36529887 DOI: 10.1111/jsr.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/10/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
During pregnancy many women may experience negative emotions and sleep disturbances. This systematic review and meta-analysis was conducted to assess the efficacy of cognitive behavioural therapy for insomnia (CBT-I) or sleep disturbance in pregnant women. From the earliest available publications to 15 April 2022, seven electronic literature databases were searched: PubMed, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure, Wanfang Data, and VIP Database for Chinese Science and Technology Journal. Randomised controlled trials of CBT-I in pregnant women with insomnia or sleep disorders were included. The methodological bias of the included studies was assessed using the Cochrane risk of bias tool. The meta-analysis was performed using RevMan 5.4 software. Stata Statistical Software: Release 15 was used for sensitivity analysis and publication bias. We included eight randomised controlled trials involving 743 pregnant women. Meta-analysis showed that, compared with the control group, CBT-I significantly improved the Insomnia Severity Index (mean difference [MD] = -4.25, 95% confidence interval [CI, -6.32, -2.19], p < 0.001), The Pittsburgh Sleep Quality Index (MD = -3.30, 95% CI [-4.81, -1.79], p < 0.001), sleep onset latency (standardised mean difference [SMD] = -1.25, 95% CI [-2.01, -0.50], p = 0.001), anxiety (SMD = -0.99, 95% CI [-1.32, -0.67], p < 0.001), and depression (SMD = -0.40, 95% CI [-0.72, -0.07], p = 0.02). No significant differences were found in total sleep time (SMD = 0.31, 95% CI [-0.54, 1.17], p = 0.47) and sleep efficiency (SMD = 0.80, 95% CI [-0.53, 2.13], p = 0.24). CBT-I significantly improved pregnant women's sleep quality, insomnia severity, depression, and anxiety. This meta-analysis provides evidence that CBT-I is valid for insomnia or sleep disturbances during pregnancy.
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Affiliation(s)
- Xinyi Zheng
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheng Zhu
- Tianjin University of Traditional Chinese Medical, Tianjin, China
| | - Juan Chen
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiaying He
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuhang Zhu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Zhang
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Fan Qu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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10
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Wang J, Huang Y, Li Y, Wu L, Cao D, Cao F. Sleep-related attentional bias: Development and validation of a Chinese version of the brief sleep-associated monitoring index in pregnant women. J Psychosom Res 2022; 163:111052. [PMID: 36228433 DOI: 10.1016/j.jpsychores.2022.111052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to develop a Chinese version of the brief Sleep-Associated Monitoring Index (SAMI-B), and examine its psychometric properties among pregnant women. METHODS This cross-sectional study conveniently recruited 665 pregnant women from two tertiary hospitals in Shandong, China; 110 completed a retest survey within two or three weeks after completing the baseline questionnaires. The scale was developed following established guidelines. Participants completed the SAMI-B, SAMI, Insomnia Severity Index, Pittsburgh Sleep Quality Index, Pre-Sleep Arousal Scale, Edinburgh Postnatal Depression Scale, and Generalized Anxiety Disorder-7 Scale. Psychometric evaluation included reliability (internal consistency, test-retest reliability) and validity (construct, item and concurrent validity; and diagnostic accuracy). RESULTS The Chinese SAMI-B demonstrated uni-dimensionality construct, appropriate item fit and functioning; acceptable internal consistency (McDonald's ω = 0.917) and test-retest reliability (intraclass correlation = 0.736). It was significantly correlated with the SAMI (correlation coefficient = 0.765,P < 0.001) and other sleep-related measurements (correlation coefficients = 0.412-0.638, Ps < 0.001). The SAMI-B displayed a comparable area under the curve (0.739, 95% CI: 0.703-0.772) with the SAMI in detecting insomnia symptoms. The optimal cutoff point (18) presented a sensitivity of 0.765 and a specificity of 0.615 in distinguishing individuals with and without insomnia symptoms. After controlling for general information, the differences in the SAMI-B scores between those with or without insomnia symptoms remained significant (OR = 1.16, 95% CI: 1.12-1.20). CONCLUSION The SAMI-B may be an effective alternative for clinicians and researchers to screen or track vulnerable individuals for prenatal insomnia symptoms.
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Affiliation(s)
- Juan Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Yongqi Huang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Yang Li
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Liuliu Wu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Danfeng Cao
- The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong Province 250012, China.
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11
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Chen H, Zou Y, Shi H, Ma H, Huang W, Wang S, Lu J. COVID-19 affects psychological symptoms of pregnant women indirectly by increasing their maternal concerns. J Affect Disord 2022; 317:79-83. [PMID: 36030996 PMCID: PMC9420000 DOI: 10.1016/j.jad.2022.08.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/11/2022] [Accepted: 08/21/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Pregnant women themselves are at higher risk for psychological symptoms. The impact of ongoing COVID-19 may increase the risk. However, it is uncertain whether COVID-19 affects pregnant women's psychological symptoms directly or indirectly being mediated. METHODS This survey was conducted in four obstetrics and gynecology hospitals in Beijing from February 28, 2020, to April 26, 2020. Pregnant women who visited the antenatal-care clinic were mobilized to finish the online questionnaires, including the Generalized Anxiety Disorder 7-Item Scale, Patient Health Questionnaire-9, Connor-Davidson resilience scale, and Insomnia Severity Index. RESULTS A total of 828 pregnant women were included in the analysis. The estimated self-reported rates of anxiety, depression, insomnia, and any of the three were 12.2 %, 24.3 %, 13.3 %, and 33.1 %, respectively. Mediating effect analysis showed that pregnant women's response to COVID-19 was not directly associated with psychological symptoms but indirectly through the mediating effect of maternal concerns, which accounted for 32.35 % of the total effect. Stratified analysis by psychological resilience showed that women's attitude toward COVID-19 (OR, 2.68, 95 % CI: 1.16-6.18) was associated with a higher risk of psychological symptoms in those with poor psychological resilience. LIMITATIONS The study was a non-probability sampling survey, and the causal relationship between maternal concerns and psychological symptoms could not be determined due to the study's design. CONCLUSIONS Under public health emergencies such as COVID-19, routine antenatal care should still be prioritized, and concerns related to childbirth-related caused by such emergencies should also be addressed, especially for those with weak psychological resilience.
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Affiliation(s)
- Hongguang Chen
- Peking University Sixth Hospital (Institute of Mental Health), Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100083, China
| | - Yusong Zou
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Shi
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hongyan Ma
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Wenyang Huang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Shuzhen Wang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Junli Lu
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
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12
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Cevik A, Onat Koroglu C, Karacam Z, Gokyildiz Surucu S, Alan S. Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1405-1421. [PMID: 35912813 DOI: 10.1177/10547738221112748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This systematic review and meta-analysis study aims to determine the effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression symptoms during pregnancy. Reviews were done through PubMed, EBSCO (Medline, CINAHL), Embase (OVID), Web of Science, PsycINFO, TR Index, Turkish Thesis Center databases using (pregnancy OR pregnant) and (sleep OR sleep disorders OR insomnia), and (anxiety OR depression) keywords between April and May 2021. The meta-analysis included 48 articles (sample: 77,299). It was found that the Covid-19 pandemic did not affect the prevalence of depression symptoms and anxiety during pregnancy, but it increased insomnia. While insomnia ratio was reported 39.6% (95% CI: 0.253-0.560) in the studies conducted before the pandemic, it was reported 88.8% (95% CI: 0.821-0.921) in the studies conducted during the pandemic. This study found that the Covid-19 pandemic did not have effects on depression symptoms and anxiety, but it increased insomnia complaints.
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El-Sherbeeny N, El Tantawy A, Ibrahim O, Elsayed M, El-Okda N, Hassan H. Insomnia and sleep quality among women during the perinatal period. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00209-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Insomnia is the most common sleep disorder affecting sleep quality and quality of life among women during the perinatal period. The aim of the study is to study the frequency of insomnia and sleep quality among perinatal women and their effect on quality of life: 131 participants; 64 perinatal and 67 control groups from the outpatient clinics of Suez Canal University Hospital, Ismailia, Egypt. DSM-5 criteria were used to diagnose insomnia. Sleep quality was assessed using PSQI, and SF-36 questionnaire was used for assessment of health-related quality of life.
Results
Insomnia was statistically significant higher among the perinatal group than the control; 28.1% and 10.4%, respectively (P < 0.05). The perinatal women had poor sleep quality as compared with the control group with a higher mean global PSQI score; 8.02 ± 2.97 and 4.97 ± 2.45, respectively (P < 0.05). The quality of life in the perinatal group was lower than the control group with scores of 54.96 ± 14.63 versus 62.34 ± 14.63, respectively.
Conclusions
Insomnia and poor sleep quality are found in higher frequency in perinatal women than their counterpart control. The study also showed a significant impact of these changes on maternal HRQoL.
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14
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Wang R, Xu M, Yang W, Xie G, Yang L, Shang L, Zhang B, Guo L, Yue J, Zeng L, Chung MC. Maternal sleep during pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis. J Diabetes Investig 2022; 13:1262-1276. [PMID: 35171528 PMCID: PMC9248434 DOI: 10.1111/jdi.13770] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/26/2022] [Accepted: 02/11/2022] [Indexed: 11/28/2022] Open
Abstract
AIM/INTRODUCTION Sleep problem is an important public health concern worldwide. We conducted a meta-analysis to quantitatively evaluate whether sleep duration associated with pregnancy outcomes, and the associations were modified by important characteristics of studies. MATERIALS AND METHODS Basing on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) databases, we searched for the published literature related to maternal sleep duration and adverse pregnancy outcomes before 30 June, 2021. We conducted risk of bias assessment, subgroup analyses and sensitivity analysis. The relative risks (RR) or odds ratios (OR) with 95% confidence intervals (CI) were used to estimate the pooled effects. RESULTS 5246 references were identified through databases searching, 41 studies were included in the study. Pregnant with short sleep duration had 1.81 times (95% CI 1.35-2.44, P < 0.001) risk of gestational diabetes mellitus (GDM). The association between short sleep duration and the risk of gestational hypertension (GH), cesarean section (CS), low birthweight (LBW), preterm birth (PTB) and small for gestational age (SGA) were not significant (P > 0.05). Furthermore, long sleep duration was significantly correlated with GDM (OR 1.24. 95% CI 1.12-1.36, P < 0.001) and CS (OR 1.13. 95% CI 1.04-1.22, P = 0.004), while long sleep duration was not linked with GH, LBW, PTB and SGA (P > 0.05). CONCLUSIONS Short / long sleep duration appeared to be associated with adverse pregnancy outcome, specifically with an increased risk of GDM. Sleep should be systematically screened in the obstetric population.
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Affiliation(s)
- Ruiqi Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Mengmeng Xu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Guilan Xie
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Liren Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Li Shang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China.,Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, P.R. China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Leqian Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Jie Yue
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Mei Chun Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts Boston, United States of America
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15
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Yang JP, Lin RJ, Sun K, Gao LL. Incidence and correlates of insomnia and its impact on health-related quality of life among Chinese pregnant women: a cross-sectional study. J Reprod Infant Psychol 2022:1-12. [PMID: 34989304 DOI: 10.1080/02646838.2021.2020228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aims of this study were to examine the incidence and correlates of insomnia and its impact on health-related quality of life among Chinese pregnant women. METHOD A cross-sectional study was performed from November 2018 to April 2019 in a university-affiliated general hospital in Guangzhou, China. Seven hundred and seventeen pregnant women completed the 36-item Short-Form Health Survey (SF-36), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), and the obstetric and sociodemographic data sheet. FINDINGS 24.3% of the pregnant women suffered from insomnia. Compared with women without insomnia, those with insomnia had a significantly lower health-related quality of life during pregnancy. Maternal age, educational level, occupation, economic status, insurance coverage, gestational age, the woman's relationship with her mother-in-law and anxiety were significantly associated with insomnia among pregnant women. CONCLUSION The incidence of insomnia among pregnant women is high, and insomnia is negatively correlated with health-related quality of life. Appropriate measures and practical therapeutic programmes should be provided to prevent the adverse effects of insomnia in pregnant women with advanced maternal age, lower education, lower economic status, unemployment, lack of insurance coverage, unsatisfied with their relationships with their mothers-in-law, and suffering from anxiety symptoms, especially in the third trimester.
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Affiliation(s)
- Jing-Ping Yang
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Rong-Jin Lin
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ke Sun
- The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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16
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Zou H, Tao Z, Zhou Y, Zhang Z, Zhang C, Li L, Yang J, Wang Y, Huang W, Wang J. Perceived Stress Positively Relates to Insomnia Symptoms: The Moderation of Resilience in Chinese Pregnant Women During COVID-19. Front Psychiatry 2022; 13:856627. [PMID: 35573361 PMCID: PMC9092980 DOI: 10.3389/fpsyt.2022.856627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The government's COVID-19 pandemic response lockdown strategy had a negative psychological and physical impact on individuals, which necessitated special care to pregnant women's mental health. There has been no large-scale research on the underlying relationship between perceived stress and insomnia symptoms in pregnant Chinese women up to this point. During the COVID-19 pandemic, we wanted to see if there was an association between perceived stress and insomnia symptoms, as well as the moderating impact of resilience for Chinese pregnant women. METHODS This cross-sectional study examined 2115 pregnant women from central and western China using multi-stage sampling methodologies. A systematic questionnaire was used to collect information on sleep quality, perceived stress, and resilience using the Insomnia Severity Index, Perceptual Stress Scale, and Connor and Davidson Resilience Scale. To assess the moderating influence of resilience, hierarchical regressions were used. RESULTS During the COVID-19 pandemic, 18.53% of respondents (N = 2115) reported experiencing sleeplessness. In pregnant women, perceived stress was positively linked with insomnia symptoms (p < 0.001). Furthermore, resilience significantly attenuated the influence of perceived stress on insomnia symptoms in Chinese expectant mother (βinteraction = -0.0126, p < 0.001). CONCLUSION Pregnant women with strong resilience were less influenced by perceived stress than those with poor resilience. The findings of this study might give empirical proof that health care professionals should identify the relevance of reducing perceived stress in pregnant women with poor resilience and provide better treatment and support when necessary.
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Affiliation(s)
- Hongyu Zou
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Zhen Tao
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Chunyan Zhang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Linling Li
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Wei Huang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianhong Wang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
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17
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Insomnia evaluation and treatment during peripartum: a joint position paper from the European Insomnia Network task force "Sleep and Women," the Italian Marcè Society and international experts task force for perinatal mental health. Arch Womens Ment Health 2022; 25:561-575. [PMID: 35419652 PMCID: PMC9072480 DOI: 10.1007/s00737-022-01226-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/27/2022] [Indexed: 12/22/2022]
Abstract
Insomnia symptoms are frequent during peripartum and are considered risk factors for peripartum psychopathology. Assessing and treating insomnia and related conditions of sleep loss during peripartum should be a priority in the clinical practice. The aim of this paper was to conduct a systematic review on insomnia evaluation and treatment during peripartum which may be useful for clinicians. The literature review was carried out between January 2000 and May 2021 on the evaluation and treatment of insomnia during the peripartum period. The PubMed, PsycINFO, and Embase electronic databases were searched for literature published according to the PRISMA guidance with several combinations of search terms "insomnia" and "perinatal period" or "pregnancy" or "post partum" or "lactation" or "breastfeeding" and "evaluation" and "treatment." Based on this search, 136 articles about insomnia evaluation and 335 articles on insomnia treatment were found and we conducted at the end a narrative review. According to the inclusion/exclusion criteria, 41 articles were selected for the evaluation part and 22 on the treatment part, including the most recent meta-analyses and systematic reviews. Evaluation of insomnia during peripartum, as for insomnia patients, may be conducted at least throughout a clinical interview, but specific rating scales are available and may be useful for assessment. Cognitive behavioral therapy for insomnia (CBT-I), as for insomnia patients, should be the preferred treatment choice during peripartum, and it may be useful to also improve mood, anxiety symptoms, and fatigue. Pharmacological treatment may be considered when women who present with severe forms of insomnia symptoms do not respond to nonpharmacologic therapy.
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18
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Björkstedt SM, Kautiainen H, Tuomi U, Gissler M, Pennanen P, Eriksson JG, Laine MK. Maternal use of sedative drugs and its effects on pregnancy outcomes: a Finnish birth cohort study. Sci Rep 2021; 11:4467. [PMID: 33627788 PMCID: PMC7904770 DOI: 10.1038/s41598-021-84151-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 02/08/2021] [Indexed: 01/08/2023] Open
Abstract
Our aim was to evaluate maternal use of sedative drugs before, during, and after pregnancy and to assess the influence of use of these drugs on pregnancy outcomes. The study cohort (N = 6231) consists of all primiparous women, who lived in the city of Vantaa, Finland, and who delivered a singleton between 2009 and 2015. Data were obtained from Finnish national health registers. Of the women, 3.2% (n = 202) purchased at least once sedative drugs within 90 days before conception, during pregnancy and/or within 90 days after delivery. Sedative drug users were older, less likely to cohabitate, more often smokers, had lower educational attainment and had more mental diseases (for all p < 0.001) compared with non-users. Sedative drug users purchased more often antidepressants and drugs for the alimentary tract, musculoskeletal and nervous system than non-users (for all p < 0.001). No adverse birth or pregnancy outcomes were found in the group using sedative drugs compared with the non-users. Studies in larger cohorts are needed to confirm our study findings.
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Affiliation(s)
- Satu-Maarit Björkstedt
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Social Services and Health Care Division, City of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | | | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Karolinska Institute, Stockholm, Sweden
| | | | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynecology and Human Potential Translational Research Programme, National University Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore
- Agency for Science, Technology and Research (A*STAR), Singapore Institute for Clinical Sciences (SICS), Singapore, Singapore
| | - Merja K Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Folkhälsan Research Center, Helsinki, Finland.
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19
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Wang J, Zhou Y, Qian W, Zhou Y, Han R, Liu Z. Maternal insomnia during the COVID-19 pandemic: associations with depression and anxiety. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1477-1485. [PMID: 33891160 PMCID: PMC8063170 DOI: 10.1007/s00127-021-02072-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/29/2021] [Indexed: 12/04/2022]
Abstract
BACKGROUND The COVID-19 outbreak has made people more prone to depression, anxiety and insomnia, and females are at a high risk of developing these conditions. As a special group, pregnant and lying-in women must pay close attention to their physical and mental health, as both have consequences for the mother and the fetus. However, knowledge regarding the status of depression, anxiety and insomnia among these women is limited. AIM This study aimed to examine insomnia and psychological factors among pregnant and lying-in women during the COVID-19 pandemic and provide theoretical support for intervention research. METHODS In total, 2235 pregnant and lying-in women from 12 provinces in China were surveyed; their average age was 30.25 years (SD = 3.99, range = 19-47 years). PARTICIPANTS AND SETTING The participants completed electronic questionnaires designed to collect demographic information and assess levels of depression, anxiety and insomnia. RESULTS The prevalence of insomnia in the sample was 18.9%. Depression and anxiety were significant predictors of insomnia. Participants in high-risk areas, those with a disease history, those with economic losses due to the outbreak, and those in the postpartum period had significantly higher insomnia scores. DISCUSSION The incidence of insomnia among pregnant and lying-in women is not serious in the context of the epidemic, which may be related to the sociocultural background and current epidemic situation in China. CONCLUSION Depression and anxiety are more indicative of insomnia than demographic variables.
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Affiliation(s)
- Jiazhou Wang
- grid.9227.e0000000119573309Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101 China ,grid.410726.60000 0004 1797 8419Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Yongjie Zhou
- grid.452897.50000 0004 6091 8446Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, 518020 China
| | - Wei Qian
- grid.9227.e0000000119573309Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101 China
| | - Yueyue Zhou
- grid.9227.e0000000119573309Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101 China ,grid.410726.60000 0004 1797 8419Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Ru Han
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Zhengkui Liu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
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20
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Sedov ID, Anderson NJ, Dhillon AK, Tomfohr-Madsen LM. Insomnia symptoms during pregnancy: A meta-analysis. J Sleep Res 2020; 30:e13207. [PMID: 33140514 DOI: 10.1111/jsr.13207] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Abstract
Reports of sleep disturbances are common during pregnancy, yet estimates of prevalence of insomnia symptoms during pregnancy vary widely. The goals of the current review were to summarize the existing data on prevalence of insomnia symptoms during pregnancy and to explore potential moderators, including trimester, gestational age, maternal age, symptoms of anxiety and symptoms of depression. A systematic search of PubMed, PsycInfo and Web of Science was conducted for articles published from inception up to June 2020. In total, 24 studies with a total of 15,564 participants were included in the analysis. The overall prevalence of insomnia symptoms during pregnancy was 38.2%. Trimester was a significant moderator, such that prevalence of insomnia symptoms was higher in the third trimester (39.7%) compared to first (25.3%) and second (27.2%) trimesters. No other variables significantly moderated the prevalence of insomnia symptoms. The results of the current meta-analysis suggest that the prevalence of insomnia symptoms is higher during pregnancy, particularly in the third trimester. Future research should examine the efficacy and safety of insomnia treatments with this population.
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Affiliation(s)
- Ivan D Sedov
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Ashley K Dhillon
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada
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21
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Liu D, Liu S, Zhu L, Li D, Huang D, Deng H, Guo H, Huang D, Liao Y, Mao Z, Miao Q, Liu W, Xiu M, Zhang X. Prevalence and Related Factors of Insomnia Among Chinese Medical Staff in the Middle and Late Stage of COVID-19. Front Psychiatry 2020; 11:602315. [PMID: 33364990 PMCID: PMC7750428 DOI: 10.3389/fpsyt.2020.602315] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022] Open
Abstract
Background: The outbreak of novel coronavirus disease (COVID-19) has brought serious psychological pressure to people, especially medical health staff. At present, there are few studies on insomnia and related factors of medical health staff in the middle and late stage of the epidemic of COVID-19. Therefore, the purpose of this study was to investigate the prevalence of insomnia and its related risk factors among medical workers in China in the middle and later stage of COVID-19 epidemic, as well as the relationship between insomnia and psychological resilience. Methods: From February 14 to March 29, 2020, a cross-sectional survey was conducted among 606 medical staff in China through Ranxing Technology's "SurveyStar" network platform. All subjects were assessed with the Insomnia Severity Index (ISI) and simplified Chinese version of Connor-Davidson Resilience scale (CD-RISC-10). Results: In the middle and later stages of the COVID-19 outbreak, the incidence of insomnia among medical staff was 32.0%. Compared with non-insomnia group, the insomnia group had younger age, lower education level, longer daily working hours and less psychological resilience. In addition, the prevalence of insomnia was higher in medical staff with a history of somatic diseases. The severity of insomnia of Chinese medical staff was associated with age, education level, daily working hours, psychological resilience and somatic diseases. Conclusions: Our study shows that nearly 1/3 of Chinese medical workers suffer from insomnia nearly a month after the COVID-19 outbreak. Compared with the general population, medical staff who are working with COVID are more prone to insomnia. Risk factors for insomnia include younger age, lower education level, longer working hours per day, and physical illness. The tenacious dimension of psychological resilience is a protective factor for insomnia.
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Affiliation(s)
- Dianying Liu
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Shaohua Liu
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Lin Zhu
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Dongbin Li
- School of Education Science, Gannan Normal University, Ganzhou, China
| | - Donghua Huang
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Hongdong Deng
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Huiyun Guo
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Dan Huang
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Yuanping Liao
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Zhongzhen Mao
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Qiumei Miao
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Wanglin Liu
- Department of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Xiangyang Zhang
- Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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