title: Sleep duration and quality in healthy nulliparous and multiparous women across pregnancy and post-partum.
abstract: BACKGROUND
  Longitudinal studies of sleep during normal pregnancy and post-partum are rare, and interpretation of the findings is often hampered by methodological issues. Consequentially, there is still limited information on what constitutes normal sleep quality and quantity across pregnancy and early post-partum, for both nulliparous and multiparous women.
  
  
  OBJECTIVE
  To quantify the change and variability in sleep duration and quality across pregnancy and post-partum for healthy nulliparous and multiparous women.
  
  
  METHODS
  Nineteen women (eight nulliparous and 11 multiparous) wore an actigraph and completed a sleep diary to objectively measure sleep for seven nights during the second trimester, one week prior to delivery, and at one and six weeks post-partum. Mixed model analysis of variance and logistic regression were used to investigate changes in sleep across this timeframe.
  
  
  RESULTS
  The largest changes in sleep occurred in the first week post-partum (1.5 h less sleep than during pregnancy, three times more sleep episodes in 24 h, 70% of women regularly napping during the day, and greatest day-to-day variability in sleep). Compared to multiparas, nulliparas generally had less efficient sleep, spent more time in bed and had greater wake after sleep onset in the second trimester, and spent less time in bed and had fewer sleep episodes a day at one week post-partum.
  
  
  CONCLUSIONS
  These changes should be used to inform women about the extent of change in sleep, particularly early post-partum, and to help health-care providers identify women experiencing severe sleep loss and disruption and discuss possible coping strategies with them.
authors.affiliation: Sleep/Wake Research Centre, Research School of Public Health, Massey University, Wellington, New Zealand. t.l.signal@massey.ac.nz
authors.forename: T Leigh
authors.initials: TL
authors.lastname: Signal
authors.forename: Philippa H
authors.initials: PH
authors.lastname: Gander
authors.forename: Michel R
authors.initials: MR
authors.lastname: Sangalli
authors.forename: Noémie
authors.initials: N
authors.lastname: Travier
authors.forename: Ridvan T
authors.initials: RT
authors.lastname: Firestone
authors.forename: Jeremy F
authors.initials: JF
authors.lastname: Tuohy
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D010298:Parity / Q000502:physiology; D017286:Polysomnography; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy / Q000502:physiology*; D011262:Pregnancy Trimester, Second / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D013997:Time Factors