Insomnia in Pregnancy Is Associated With Depressive Symptoms and Eating at Night

Abstract

Study Objectives: Deterioration in sleep quality seems to be a natural consequence of physical changes during pregnancy. It is still unclear if insomnia in pregnancy is associated with the same factors as chronic insomnia in the general population. The aim of this study was to explore the determinants of insomnia during pregnancy. Methods: The study included 266 women (mean age: 30.6 ± 5 years, weeks of pregnancy: 36 [interquartile range 32-38]) recruited at the Department of Gynecology and Obstetrics, Medical University of Warsaw. The assessment of variables was performed using the Athens Insomnia Scale (AIS), Beck Depression Inventory (BDI), Regestein Hyperarousal Scale (HS), Epworth Sleepiness Scale (ESS), General Practice Physical Activity Questionnaire, and a semi-structured interview about different sleep disorders. Results: Almost 40% of the women in our study received a diagnosis of insomnia based on AIS cutoff scores. The between-group analyses indicated that HS score, BDI score, eating at night, legs tingling, nightmares, snoring, and myoclonus differentiated the groups of individuals with insomnia from those without insomnia. Other variables were not significantly different between the groups. We divided individuals with insomnia in terms of insomnia duration: 49% developed insomnia at least 1 year before the study onset and 39.6% during pregnancy. For further analyses we used only the women in whom insomnia developed during pregnancy. Logistic regression confirmed that depressive symptoms (BDI) and eating at night were significant predictors of insomnia in pregnancy. Conclusions: Depressive symptoms and night eating are key factors related to insomnia developed during pregnancy.

Insomnia in Pregnancy: Prevalence and Predisposing Factors in a Developing Country

“…The prevalence rate of 32.5% obtained in this study represents almost a third of all the respondents. This rate is comparable to similar studies done in this environment and other places with reported prevalence rate between 35.5% and 47.3% [6,7]. But much lower than rates of 56.1% and 61.6% reported from studies among Chinese and Norwegian pregnant women respectively [4,5].…”

“…While a recent study done in Norway reported a higher prevalence of 61.6% [5]. In a more recent study done in 2017 in warsaw, a prevalence rate of 39.8% was reported among women in their last trimester [6]. A similar study done in Nigeria reported a prevalence rate of 47.3% with more cases of insomnia occurring during the 3 rd trimester of pregnancy [7].…”

Sleep disturbances and modulations in inflammation: Implications for pregnancy health

“…Sleep is gaining recognition as an important factor to consider when studying or treating pregnant women. For example, many epidemiological reports have linked poor sleep or insomnia to poor health outcomes, including depression (Okun, Kiewra, Luther, Wisniewski, & Wisner, 2011;Okun, Kiewra, Luther, et al, 2011;Volkovich, Tikotzky, & Manber, 2016;Wolynczyk-Gmaj et al, 2017;Yang et al, 2017;Hux, Roberts, & Okun, 2017), preterm birth (Okun, Luther, Prather, et al, 2011;Blair, Porter, Leblebicioglu, & Christian, 2015;Li et al, 2016) and longer labor times (Evans, Dick, & Clark, 1995;Lee & Gay, 2004). The undisputed association between stress and sleep is particulary poignant in pregnancy, as stress is independently associated with poor pregnancy outcomes (Okun, Roberts, Begley, Catov, & Patrick, 2013;Palagini et al, 2014;Hux et al, 2017).…”

“…With regard to infant outcomes, our knowledge is even more limited. Historically, the emphasis has been on sleep-disordered breathing (SDB) or sleep apnea and infant outcomes (Bourjeily et al, 2010;Chen et al, 2012;Franklin et al, 2000;Koken et al, 2007;Tauman et al, 2011); however, recent data have emphasized sleep quality and insomnia and how they impact the neonate (Dorheim et al, 2012;Okun, Kiewra et al, 2011;Okun et al, 2015;Rognmo, Sivertsen, & Eberhard-Gran, 2016;Sivertsen, Hysing, Dorheim, & Eberhard-Gran, 2015;Wolynczyk-Gmaj et al, 2017).…”

Hyperarousal Scale: Italian Cultural Validation, Age and Gender Differences in a Nonclinical Population

“…Hyperarousal has also been related to depression. Szelenberger and Niemcewicz [9] found correlations between hyperarousal and depression scores, demonstrating relationships with the cognitive and affective aspects of depression; moreover, depressive symptoms and night eating were key factors related to insomnia [10]. Higher levels of self-reported arousal were associated with distress from interpersonal problems; individuals with insomnia who reported more distress from interpersonal problems tended to have more severe insomnia and cognitive pre-sleep arousal, possibly due to rumination [11].…”