Effects of Two Physical Activity Interventions on Sleep and Sedentary Time in Pregnant Women

Abstract

Pregnancy is often associated with poor sleep and high sedentary time (SED). We investigated the effect of physical activity (PA) interventions on sleep and SED in pregnant women. A secondary analysis of a randomized controlled trial (n = 219) explored the effect of structured supervised exercise training (EXE) or motivational counseling on PA (MOT) compared to standard prenatal care (CON) on sleep and SED during pregnancy. Three times during pregnancy, sleep was determined by the Pittsburgh Sleep Quality Index (PSQI) and SED by the Pregnancy Physical Activity Questionnaire (PPAQ). Also, a wrist-worn consumer activity tracker measured sleep and SED continuously. Data from the activity tracker confirmed that sleep time decreases, and SED increases by approx. 30 and 24 min/day, respectively, from baseline (maximum gestational age (GA) week 15) to delivery. Compared to CON, the global PSQI score was better for EXE in GA week 28 (-0.8 [-1.5; -0.1], p = 0.031) and for both EXE and MOT in GA week 34 (-1 [-2; -0.5], p = 0.002; -1 [-2; -0.1], p = 0.026). In GA week 28, SED (h/day) from PPAQ was lower in EXE compared to both CON and MOT (-0.69 [-1; -0.0], p = 0.049; -0.6 [-1.0; -0.02], p = 0.042). In conclusion, PA interventions during pregnancy improved sleep quality and reduced SED.

Trial registration: ClinicalTrials.gov NCT03679130.

Keywords: FitMum; Pittsburgh Sleep Quality Index; Pregnancy Physical Activity Questionnaire; consumer activity tracker; maternal health; randomized controlled trial.

Figure 1

Baseline-constrained comparison between groups based on the means of the Pittsburgh Sleep Quality Index global score. Baseline, gestational age of maximum 15 weeks; CON (gray color), standard care; EXE (blue color), structured supervised exercise training; GA, gestational age; MOT (red color), motivational counseling on physical activity. * EXE compared to CON at GA week 28 (p = 0.031), ** EXE compared to CON at GA week 34 (p = 0.002), $ MOT compared to CON at GA week 34 (p = 0.026).

Figure 2

Baseline-constrained comparison between groups based on the means of sedentary time from the Pregnancy Physical Activity Questionnaire. Baseline, gestational age of maximum 15 weeks; CON (grey color), standard care; EXE (blue color), structured supervised exercise training; GA, gestational age; hr, hour; MOT (red color), motivational counseling on physical activity. * EXE compared to CON at GA week 28 (p = 0.0498), ** EXE compared to MOT at GA week 28 (p = 0.042).

Figure 3

Baseline-constrained comparison between groups based on the activity tracker’s mean of total sleep and sedentary time. Baseline, gestational age of maximum 15 weeks; CON (gray color), standard care; EXE (blue color), structured supervised exercise training; GA, gestational age. h, hour; MOT (red color), motivational counseling on physical activity.

Figure 4

Average and 95% confidence interval of total sleep time and sedentary time before COVID-19 [physical intervention only, participants (n = 120) started and finished the intervention before COVID-19] (full line) and during COVID-19 [online intervention only, participants (n = 63)] (dotted line)], respectively. CON (gray color), standard care; EXE (blue color), structured, supervised exercise training; h, hour; MOT (red color), motivational counseling on physical activity. * EXE who received the physical intervention compared to EXE who received online intervention from randomization (gestational age of maximum 15 weeks) to delivery (p = 0.032).

Figure 5

Differences in the total sleep time between the Pittsburgh Sleep Quality Index (PSQI) and the activity tracker vs. the average of sums at the gestational age of maximum 15 weeks (A), GA week 28 (B), GA week 34 s (C). h, hour; GA, gestational age; TST, total sleep time; LOA, the limit of agreements.