Although sleep disturbance is commonly reported in pregnancy, there have been few studies on sleep characteristics in pregnancy. In this study, all women attending the antenatal clinic at Sapporo Medical College Hospital for 1 month during autumn and 3 months during winter were surveyed with a questionnaire and sleep log. Of the 192 patients, 169 (88.0%) stated that sleep was altered from their usual experience. A principal components analysis identified three sleep factors from the ten items in the measure of sleep used (Sleep Log). The three factors were: Sleep Duration and Quality, Insomnia and Daytime Alertness. Although no significant differences across trimesters were found on the three sleep factors, Sleep Duration and Quality, and Insomnia were worst during the first trimester. Sleep normalized in the second trimester, but the third trimester was characterized by increased Insomnia and decreased Daytime Alertness. The most frequent reasons cited by women for sleep alterations were urinary frequency, backache or ache in the hips and fetal movement. Contingency X2 analyses were used to investigate a relationship between the frequency of reporting the reasons and the trimester of pregnancy. Significant increases were found in reporting as the reasons for sleep difficulties, fetal movement in the third trimester, and heartburn, nausea and vomiting in the first trimester. The description of sleep patterns during pregnancy has clinical relevance as sleep alterations in pregnancy are common.
Menstrually Related Disorders (MRDs) are quite preva lent, and in some women they are severe enough to warr ant treatment. In most of the literature and in clin ical practice, the focus has been on the premenstrual period, and most frequently the descriptive diagnosis given reflects that focus (e.g., Premenstrual syndrome The report has been sent to several active distin guished investigators in the held who were not pres ent in the group discussion and were anticipated to have different opinions on at least some of the points. We specmcally tried to get responses from those who would not agree to the concept of MRDs. Rather, we hoped that they will make the point for emphasizing the premenstrual period and PMS. We also tried to get differing opinions on pathophysiology and treatment. The following is a summary of the points on which the group felt that there was a consensus as well as the points on which a debate evolved and the only agree ment was to disagree. We did not attempt to produce any specmc proposal. The existence of symptoms and signs whose appearance or changes in severity are men strually related was not questioned. The possible po litical ramihcations of considering situations to be "dis orders" were not the subject of the scientmc discussion.
THE NAME ConsensusMenstrually Related Disorder(s) (MRDs) has been agreed upon as a general term that applies to the vari-
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