Sleep quality during pregnancy: associations with depressive and anxiety symptoms

Acta Obstet Gynecol Scand. 2017 Feb;96(2):198-206. doi: 10.1111/aogs.13056. Epub 2016 Dec 7.

Abstract

Introduction: Sleep disturbances are common during pregnancy, yet underdiagnosed and under-investigated. We evaluated sleep quality during pregnancy and assessed associated factors, especially depressive and anxiety symptoms.

Material and methods: A total of 78 healthy pregnant women from the FinnBrain Birth Cohort Study were studied twice prospectively during pregnancy (in mid-pregnancy and late pregnancy). Sleep quality was evaluated by the Basic Nordic Sleep Questionnaire, depressive symptoms by the Edinburgh Postnatal Depression Scale, and anxiety symptoms by the State-Trait Anxiety Inventory.

Results: Poor general sleep quality, difficulty falling asleep, the number of nocturnal awakenings per night, and too-early morning awakenings increased in late pregnancy compared with mid-pregnancy (all p-values < 0.020). The total insomnia score (p < 0.001) and sleep latency increased (p = 0.005), but sleep duration and preferred sleep duration did not change. Women tended to snore more often in late pregnancy, but apneas remained rare. Almost one-fourth of the women reported both morning and daytime sleepiness, but the frequencies did not increase during the follow up. In late pregnancy, depressive and anxiety symptoms were cross-sectionally related to sleep disturbances, but depressive or anxiety symptoms in mid-pregnancy were not associated with sleep disturbances in late pregnancy.

Conclusions: We found deterioration in sleep quality across pregnancy. However, no increase in negative daytime consequences was found, presumably indicating a compensatory capacity against sleep impairment. Additionally, depressive and anxiety symptoms and sleep disturbances were only cross-sectionally associated. Our study calls for further research on the factors that influence sleep disturbances during pregnancy.

Keywords: Sleep; anxiety; depression; insomnia; nocturnal breathing problem; pregnancy; sleep disturbance; sleepiness; woman.

MeSH terms

  • Adult
  • Anxiety / complications*
  • Body Mass Index
  • Cohort Studies
  • Depression / complications*
  • Female
  • Humans
  • Maternal Age
  • Parity
  • Pregnancy
  • Pregnancy Complications*
  • Pregnancy Trimesters
  • Sleep Wake Disorders / complications*
  • Snoring / complications
  • Young Adult