Prevalence of sleep deficiency in early gestation and its associations with stress and depressive symptoms

Abstract

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.

FIG. 1.

Prevalence of diary-defined sleep deficiency criteria at each individual time point and its pattern across all three time points.

FIG. 2.

Prevalence of actigraphy-defined sleep deficiency criteria at each individual time point and its pattern across all three time points.

FIG. 3.

Depressive symptoms and stress levels across time among different categories of diary-defined sleep deficiency. Data shown are untransformed raw values prior to analysis. IDS, Inventory of Depressive Symptomatology; NuPDQ, Revised Pregnancy Distress Questionnaire; PSS: Perceived Stress Scale. *significant difference between “no sleep deficiency” and “sleep deficiency” groups (p<0.01).

FIG. 4.

Depressive symptoms and stress levels across time among different categories of actigraphy-defined sleep deficiency. Data shown are untransformed raw values prior to analysis. IDS: Inventory of Depressive Symptomatology; NuPDQ: Revised Pregnancy Distress Questionnaire; PSS: Perceived Stress Scale. *significant difference between “no sleep deficiency” and “sleep deficiency” groups; ^significant difference between “mixed sleep deficiency” and “sleep deficiency” groups (p<0.01).