Objective sleep efficiency but not subjective sleep quality is associated with longitudinal risk of depression in pregnant women: A prospective observational cohort study.

Autor: Tsai SY; School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Adjunct Supervisor, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: stsai@ntu.edu.tw., Lee PL; Department of Internal Medicine, National Taiwan University, Taipei, Taiwan; Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan; Attending Physician, Division of Pulmonary and Critical Care Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: peilin1986@gmail.com., Gordon C; Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia. Electronic address: christopher.gordon@sydney.edu.au., Cayanan E; Academic Fellow, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia. Electronic address: elizabeth.cayanan@sydney.edu.au., Lee CN; Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan. Electronic address: leecn@ntu.edu.tw.
Jazyk: angličtina
Zdroj: International journal of nursing studies [Int J Nurs Stud] 2021 Aug; Vol. 120, pp. 103966. Date of Electronic Publication: 2021 Apr 29.
DOI: 10.1016/j.ijnurstu.2021.103966
Abstrakt: Background: Sleep disturbances are one of the most frequent chief complaints brought to the healthcare professionals during routine prenatal care visits. Sleep and mood disturbances are often intertwined, and depression in particular is a leading cause of disability and disease burden worldwide with women more likely to be affected than men. However, limited studies have prospectively investigated the association between sleep disturbances and longitudinal risk of depression in pregnant women, with no studies using actigraphy to objectively estimate daytime and nighttime sleep duration and the extent of sleep disruption.
Objectives: To examine the predictive and longitudinal association of objective actigraphic and subjective sleep disturbances with depressive symptoms in pregnant women.
Design: A prospective observational cohort study.
Methods: 204 1st trimester pregnant women recruited from a university-affiliated hospital provided socio-demographic and health information, wore a wrist actigraph for 7 days, and completed Pittsburgh Sleep Quality Index, Center for Epidemiologic Studies - Depression Scale, and Epworth Sleepiness Scale. Identical data collection procedures were implemented again in the 2nd and 3rd trimester, with each data collection scheduled at least 8 weeks apart. We estimated unadjusted and multivariable adjusted odds ratios and 95% confidence intervals to evaluate various types of sleep disturbances at 1st trimester and risk of depression at follow-ups.
Results: 121 (59.3%) 1st trimester women had a sleep efficiency of < 85% by actigraphy, and 92 (45.1%) had Pittsburgh Sleep Quality Index global scores > 5 indicative of poor sleep quality. In multivariable adjusted models, 1st trimester objectively measured sleep efficiency < 85% was associated with 2.71-, 3.87-, and 5.27-fold increased odds having risk of depression at 2nd trimester, 3rd trimester, and both 2nd and 3rd trimesters, respectively.
Conclusions: Healthy pregnant women experience both objective and subjective sleep disturbances during the early trimester, with a substantial proportion of them also having high depressive symptoms throughout the pregnancy. Objectively assessed poor sleep quality in the 1st trimester, but not self-reported characteristics of disturbed sleep, may play a role in the development of both elevated and persistent high depressive symptoms in pregnancy. Future studies using objective sleep measurements and clinical diagnostic interviews are warranted to examine whether an early intervention aiming at improving sleep may help reduce high depressive symptom risk and lower depression rate in women during pregnancy. Tweetable abstract: Objectively assessed poor sleep efficiency in the 1st trimester predicts both elevated and persistent high depressive symptoms in pregnancy.
Competing Interests: Conflict of Interest None.
(Copyright © 2021. Published by Elsevier Ltd.)
Databáze: MEDLINE
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