Factors related to insomnia and sleepiness in the late third trimester of pregnancy

Fernández-Alonso, Ana M.; Trabalón-Pastor, Martina; Chedraui, Peter; Pérez‐López, Faustino R.

doi:10.1007/s00404-012-2248-z

Cited by 66 publications

(58 citation statements)

References 29 publications

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“…During the third trimester, sleep disturbance and sleepiness usually increase due to sleep disorders (i.e. restless legs, sleep-related breathing disorders) and/or leg cramps and fetal activity [6]. The nocturnal sleep and daytime sleepiness symptoms in narcolepsy women have not been characterized during pregnancy but they appear to follow the pattern seen in healthy women with higher variability [1].…”

Section: Discussionmentioning

confidence: 97%

Oral l-carnitine as treatment for narcolepsy without cataplexy during pregnancy: A case report

Romigi¹,

Liguori²,

Izzi³

et al. 2015

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 97%

Oral l-carnitine as treatment for narcolepsy without cataplexy during pregnancy: A case report

Romigi¹,

Liguori²,

Izzi³

et al. 2015

Journal of the Neurological Sciences

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“…These findings support previous evidence that pregnancy confers increased risk for the development of symptoms of insomnia that are analogous to a case-definition of insomnia. 18,19,43 The utility of this tool in pregnancy may be to identify those with the most severe sleep problems that persist. This may be clinically relevant given the emerging evidence that sleep disturbance increases risk for adverse pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…41 Several studies of pregnant women report high rates of insomnia symptoms. Swanson et al 42 reported that 45% of pregnant women scored above the threshold value, and Fernandez-Alonso et al 43 identified more than 73% in late pregnancy. Manber and colleagues, 44 however, reported that only 17% of Latina women, across all trimesters, met criteria for insomnia (≥ 10) and that there was no difference across trimesters.…”

Section: S C I E N T I F I C I N V E S T I G At I O N Smentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

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Study Objectives: Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identifi cation of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation. Methods: The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specifi city, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests. Results: The ISQ identifi ed 12.6% of the sample as meeting a case defi nition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specifi city (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion. Conclusions: Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen. 1 Among the many sleep complaints associated with pregnancy, diffi culty initiating or maintaining sleep or unrefreshing sleep, are the most frequently reported issues .1,2 Collectively these sleep symptoms comprise only one aspect of clinical insomnia. According to diagnostic criteria for insomnia, one must have: (1) a diffi culty initiating or maintaining sleep, and/or unrefreshing sleep despite adequate opportunity for sleep; (2) the duration of the sleep complaint is at least 1 mo; and (3) complaints of significant impairment in social, occupational, or daily functioning. 3,4 Insomnia is associated with activation of the stress system resulting in autonomic hyperarousa l. 5,6 It is also linked to various morbidities including depressi on.7-12 Emerging evidence implicates autonomic hyperarousal as a pathway through which the risk of depression is augmen ted. 13 This association is particularly relevant for pregnant women because there is evidence that depression is associated with an increased risk for preterm birth ( PTB), 14 and prenatal depression negatively impairs maternal-child bonding and neurocognitive develo pment.14-17 Having a simple diagnostic tool to identify clinical insomnia in pregnant women could be a fi rst step in reducing the incidence of depression, autonomic hyperarousal, as well as adverse pregnancy outcomes, such as PT...

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“…Presently, the majority of published reports on sleep disturbances and/or symptoms of insomnia are from women in late pregnancy in which the rates are reported to reach upwards of > 60%. 26,46,47 Moreover, these reports do not clinically identify insomnia, only the presence of symptoms. For example, Fernandez-Alonso and colleagues used the Insomnia Severity Index to ascertain …”

Section: Sleep Deficiency In Early Gestationmentioning

confidence: 99%

“…46 While this is a commonly used instrument, the focus is on severity rather than a case definition of insomnia. Also, since a majority of women indicate experiencing symptoms of insomnia at least once in the last month, 40,48 it may not be very sensitive or specific in identifying primary insomnia in pregnant women.…”

Section: Okun Et Almentioning

confidence: 99%

Prevalence of Sleep Deficiency in Early Gestation and its Associations with Stress and Depressive Symptoms

Okun

Kline

Roberts

et al. 2013

Journal of Women's Health

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Objective: Sleep deficiency is an emerging concept denoting a deficit in the quantity or quality of sleep. This may be particularly salient for pregnant women since they report considerable sleep complaints. Sleep deficiency is linked with morbidity, including degradations in psychosocial functioning, (e.g., depression and stress), which are recognized risk factors for adverse pregnancy outcomes. We sought to describe the frequency of sleep deficiency across early gestation (10-20 weeks) and whether sleep deficiency is associated with reports of more depressive symptoms and stress. Methods: Pregnant women (N = 160) with no self-reported sleep or psychological disorder provided sleep data collected via diary and actigraphy during early pregnancy: 10-12, 14-16, and 18-20 weeks' gestation. Sleep deficiency was defined as short sleep duration, insufficient sleep, or insomnia. Symptoms of depression and stress were collected at the same three time points. Linear mixed effects models were used to analyze the data.Results: Approximately 28%-38% met criteria for sleep deficiency for at least one time point in early gestation. Women who were sleep deficient across all time points reported more perceived stress than those who were not sleep deficient ( p < 0.01). Depressive symptoms were higher among women with diary-defined sleep deficiency across all time points ( p = 0.02). Discussion: Sleep deficiency is a useful concept to describe sleep recognized to be disturbed in pregnancy. Women with persistent sleep deficiency appear to be at greater risk for impairments in psychosocial functioning during early gestation. These associations are important since psychosocial functioning is a recognized correlate of adverse pregnancy outcomes. Sleep deficiency may be another important risk factor for adverse pregnancy outcomes.

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Factors related to insomnia and sleepiness in the late third trimester of pregnancy

Abstract: Insomnia and sleepiness were prevalent in the late third trimester of pregnancy in which lifestyle factors and maternal and neonatal body composition were significant predictors.

Cited by 66 publications

References 29 publications

Oral l-carnitine as treatment for narcolepsy without cataplexy during pregnancy: A case report

Oral l-carnitine as treatment for narcolepsy without cataplexy during pregnancy: A case report

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Prevalence of Sleep Deficiency in Early Gestation and its Associations with Stress and Depressive Symptoms

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