Sources of Midsleep Awakenings in Childbearing Women

Baratte-Beebe, Kathleen R.; Lee, Kathryn

doi:10.1177/10547739922158377

Cited by 83 publications

(52 citation statements)

References 11 publications

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“…In our study, awakenings are essentially provoked by a need to urinate, often by impression of uncomfortable position, leg cramps [16], low back pain, unfavorable environment, or fetal movements [2], and less often by anxiety, gastroesophageal reflux, nightmares or frightening dreams [16] and RLS [17]. The more frequent urge to urinate is probably due to a mechanical effect of the enlarged uterus [18]. The decrease of deep sleep observed during pregnancy [15] could explain why women are more likely to be awakened by noises or light in the environment through which they would normally sleep [2].…”

Section: Discussionmentioning

confidence: 99%

Sleep and Vigilance Disorders in Pregnancy

Neau

Texier²,

Ingrand³

2009

Eur Neurol

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Objectives: To describe different sleep disorders and daytime sleepiness in a French population of randomly selected young women during pregnancy and to evaluate the frequency of these sleep disorders according to the three trimesters of pregnancy. Methods: Cross-sectional design with retrospective survey of pre-pregnancy, symptoms and prospective survey of current symptoms. Mothers were interviewed during pregnancy with a questionnaire to evaluate their sleep before pregnancy and to assess alterations in their sleep according to the trimester. Results: 871 pregnant women completed the questionnaire. The rate of pregnant women with insomnia with non-refreshing sleep and frequent awakenings increases during the second and the third trimester reaching more than 75% of the women, essentially due to an urge to urinate, movements of the fetus, backache and restless legs syndrome. Snoring also increases throughout the pregnancy with more than 18% of them snoring every night. Conversely, more than 75% of the women complained of a decrease in their vigilance and a need to nap inreased during the pregnancy. Conclusions: The subjective quality of sleep is disturbed as early as the first trimester of pregnancy and increases throughout the pregnancy, except for excessive daytime sleepiness which was more frequent during the first trimester.

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Section: Discussionmentioning

confidence: 99%

Sleep and Vigilance Disorders in Pregnancy

Neau

Texier²,

Ingrand³

2009

Eur Neurol

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“…It is clear that a substantial number of women have at least one symptom cross-sectionally (25%-40%), and this is consistent with previous literature. 2,10,21,26,38 What is new here is that less than 20% of women have persistent sleep deficiency. These findings add to the existing literature by providing evidence that a portion, but not all pregnant women, sleep poorly in early gestation, [39][40][41] and these women may benefit from targeted clinical intervention.…”

Section: Sleep Deficiency In Early Gestationmentioning

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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“…Descriptive characteristics of the sample overall and by clinically significant insomnia status appear in Table 1. The sample included 386 women in the first trimester (weeks 1-12), 492 women in the second trimester (weeks [13][14][15][16][17][18][19][20][21][22][23][24][25][26], and 411 women in the third trimester of pregnancy (weeks ‡ 27). ISI descriptive data by trimester appear in Table 2.…”

Section: Sample Characteristicsmentioning

confidence: 99%

“…[19][20][21][22][23] For most women, the disruptions to sleep continuity are caused by pregnancy factors (e.g., frequent need for urination). 24 However, between 29% and 46% of pregnant women attribute sleeplessness to factors that are not pregnancy specific, such as ''thoughts,'' 25 which likely refers to the experience of being unable to shut off their thoughts and fall asleep, common in insomnia. 26,27 For some women, difficulties initiating sleep are unrelated to physical pregnancy factors, and/ or they experience difficulties returning to sleep after a trip to the bathroom.…”

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confidence: 99%

Factors Associated with Clinically Significant Insomnia Among Pregnant Low-Income Latinas

Manber

Steidtmann

Chambers

et al. 2013

Journal of Women's Health

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Background: Poor sleep, common during pregnancy, is associated with negative health risks. The study aimed to identify predictors of clinically significant insomnia among pregnant Latinas. Methods: A total of 1289 pregnant Latinas recruited from obstetric clinics completed the Insomnia Severity Index (ISI) and questions about demographics and sleep. Results: Clinically significant insomnia (ISI ‡ 10) was present among 17% of participants. Significant correlates of clinically significant insomnia were higher scores on the Edinburgh Postnatal Depression Scale (EPDS) after removing the sleep item (47% of women with EPDS ‡ 9 and 9% with EPDS < 9), completing measures in English (rather than Spanish: 26% versus 13%), and income but not pregnancy week, age, highest education level, or marital status. The highest percentage of clinically significant insomnia (59%) was experienced by women with EPDS ‡ 9 who completed measures in English. The lowest percentage of clinically significant insomnia (6.2%) was experienced by women with EPDS < 9 who completed measures in Spanish. Conclusions: In this sample of low-income, mostly Spanish-speaking pregnant Latinas, rates of clinically significant insomnia appear to be higher than rates among nonpregnant Latinas. Rates of clinically significant insomnia are particularly high among Latinas with elevated depressive symptom severity, a known risk for insomnia. Acculturation, as indicated by completing measures in English, may be another risk specific to Latinas, possibly owing to loss of some ethnicity-specific protective factors (e.g., social support, strong family ties, and group identity). It will be important to directly test this explanation in future research.

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Sources of Midsleep Awakenings in Childbearing Women

Cited by 83 publications

References 11 publications

Sleep and Vigilance Disorders in Pregnancy

Sleep and Vigilance Disorders in Pregnancy

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

Factors Associated with Clinically Significant Insomnia Among Pregnant Low-Income Latinas

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