Sleep quality and sleep disturbances in Chinese pregnant women: a multicenter cross-sectional study.
10.3760/cma.j.cn115330-20210603-00326
- Author:
Chu Jun ZHANG
1
;
Yi Jia SU
2
;
Yan CHEN
3
;
Zhi Jie WANG
4
;
San Lian HU
5
;
Hua Jun XU
1
;
Yu Pu LIU
1
;
Xin Yi LI
1
;
Hua Ming ZHU
1
;
Hong Liang YI
1
;
Jian GUAN
1
;
Yin Cheng TENG
6
;
Shan Kai YIN
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
2. Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China Department of Nursing, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China.
3. Department of Obstetrics, the International Peace Maternity and Child Health Hospitals of China Welfare Institution, Shanghai 200233, China.
4. Department of Gynecology and Obstetrics, Shanghai Eighth People's Hospital, Shanghai 200233, China.
5. Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China Department of Nursing, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China.
6. Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China Department of Gynecology and Obstetrics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China.
- Publication Type:Multicenter Study
- MeSH:
Child;
China/epidemiology*;
Cross-Sectional Studies;
Female;
Humans;
Pregnancy;
Pregnancy Complications/epidemiology*;
Pregnant Women;
Sleep;
Sleep Quality
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2022;57(3):308-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective: This study aims to investigate the sleep quality of pregnant women in Xuhui District, Shanghai, and the related factors of sleep disturbances during pregnancy. Methods: From February 2019 to February 2021, we used online integrated sleep questionnaire (including PSQI, BQ, ESS, AIS) in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, The International Peace Maternity and Child Health Hospitals of China Welfare Institution, and Shanghai Eighth People's Hospital, to investigate the sleep quality across pregnancy. We also collected maternal physical examination results, childbearing history, sociodemographic, and other clinical data. The prevalences and related factors of various sleep disturbances in pregnant women were analyzed, including insufficient/excessive nighttime sleep, low sleep efficiency, difficulty falling asleep, poor sleep quality, insomnia, daytime sleepiness, and high risk of sleep-disordered breathing (SDB). Results: This study includes 1 898 cases in the first trimester (T1), 3 099 cases in the second trimester (T2), and 1 539 cases in the third trimester (T3). Poor sleep quality (38.6%), daytime sleepiness (mild 41.9%, moderate 17.7%, severe 2.1%), and suspicious insomnia (32.3%) are most prevalent among women in T1 (P<0.01). In comparison, short sleep time (2.7%), long sleep time (8.6%), difficulty falling asleep (12.2%), poor sleep efficiency (35.4%), very poor sleep quality (6.7%), clinical insomnia (21.8%), and high-risk SDB (6.4%) are most prevalent among women in T3 (P<0.05). During pregnancy, late gestation (OR=1.016, 95%CI: 1.006-1.025) and multiple induced/drug abortions (OR=1.329, 95%CI: 1.043-1.692) are risk factors for poor sleep quality (PSQI>5), while multiple full-term deliveries (OR=0.800, 95%CI: 0.675-0.949) is its protective factor. Advanced maternal age (OR=0.976, 95%CI: 0.956-0.997), multiple full-term deliveries (OR=0.808, 95%CI: 0.680-0.959), late gestation (OR=0.983, 95%CI: 0.974-0.992) and hypertension (OR=0.572, 95%CI: 0.401-0.814) are protective factors for daytime sleepiness (ESS>6). The high-risk pregnancy category (OR=9.312, 95%CI: 1.156-74.978) is a risk factor for insomnia (AIS≥4), while multiple full-term deliveries (OR=0.815, 95%CI: 0.691-0.961) is its protective factor. High BMI (OR=1.334, 95%CI: 1.270-1.402) and hypertension (OR=4.427, 95%CI: 2.539-7.719) are risk factors for high-risk SDB in pregnant women. Conclusions: The prevalences of various sleep disturbances are high throughout pregnancy. Noticeably, symptoms of maternal SDB develop along with pregnancy. Different types of sleep disturbances are associated with different factors. Women of high-risk pregnancy category, in late gestation, with high BMI, hypertension, a history of induced/drug abortion, or without a history of full-term delivery can be at high risk of sleep disturbances during pregnancy.
