Sleep Disparities Across Pregnancy: A Michigan Cohort Study

Abstract

Introduction: Poor sleep health during pregnancy is related to adverse pregnancy outcomes. This study aims to identify sociodemographic characteristics associated with sleep health during pregnancy and to examine how they relate to changes in sleep during pregnancy. Materials and Methods: Participants ( n = 458) were from the Michigan Archive for Research on Child Health, which is a prospective pregnancy cohort. Sociodemographic characteristics and self-reported sleep timing and quality were collected in phone interviews. This longitudinal study collected sleep parameters once during the early trimesters and once during the third trimester. Fall asleep and wake-up times were used to calculate sleep duration and sleep midpoint. Results: Compared to the third trimester, sleep duration was 12 minutes longer ( p = 0.02), fall asleep time was 21 minutes earlier ( p < 0.001), and the midpoint of sleep was 12 minutes earlier ( p = 0.01) in early trimesters. Shorter sleep duration was noted in younger women. Sleep midpoint was later in those who were younger, overweight, or obese, racial minorities, unmarried, and with lower educational levels or socioeconomic status, and who smoked before pregnancy after adjusting for covariates. After controlling for confounders, women who were not working for pay had higher likelihood of reduced sleep duration, and women who were unmarried were more likely to have a delayed sleep midpoint in the third trimester compared to the early trimesters. Conclusions: This study suggests that sleep parameters changed during pregnancy and sleep health differed by sociodemographic characteristics. Understanding sleep disparities could help with early detection of at-risk populations during prenatal care.

How do psychosocial and cultural factors influence sleep and circadian health disparities?

“…Inequalities in sleep duration, efficiency, timing, regularity, alertness, and quality are manifestations of and contributors to social injustice. Populations known to experience sleep and circadian health disparities include adolescents, indigenous people, refugees, asylum seekers, migrants, immigrants, racial and ethnic minorities, sexual and gender minorities, women, pregnant people, older adults, individuals with mental and physical illness or disabilities, some religious groups, the socioeconomically disadvantaged, the homeless, and those living in underserved rural areas (Billings et al 2021;Garbers et al 2023;Huber et al 2022;Moore et al 2023;Nandagiri et al 2023;Richter et al 2020;Roncoroni et al 2022;Schneeberger et al 2019;Yang et al 2023;Zarhin 2023). A nascent literature has begun to identify potential psycho-social-cultural determinants of sleep and circadian health disparities including social categorization, social identity, intersectionality, social power structures, socio-structural constraints, social, political, and economic context, discrimination, prejudice, and cultural sleep values (Billings et al 2021;Grandner et al 2016;Majeno et al 2023;Zarhin 2023).…”