title: Assessing sleep during pregnancy: a study across two time points examining the Pittsburgh Sleep Quality Index and associations with depressive symptoms.
abstract: OBJECTIVE
  Sleep quality seems to be an antecedent to depressive symptoms during pregnancy. We sought to 1) examine the psychometrics of the Pittsburgh Sleep Quality Index (PSQI) in pregnancy; 2) examine whether sleep quality predicted increases in depressive symptoms; and 3) compare PSQI scores across 3 or 2 levels of depressive symptoms.
  
  
  METHODS
  Each of the 252 participants completed the Beck Depression Inventory (short form) and a sleep quality measure at mid and late pregnancy.
  
  
  RESULTS
  PSQI total scores showed good internal consistency and construct validity. An improved model of the internal structure of the PSQI in pregnancy was found with 1 factor labeled Sleep Efficiency, a second labeled Night and Daytime Disturbances, and an Overall Sleep Quality component associated with, but separate from, both of these 2 factors. Although PSQI scores showed moderate stability over time, sleep disturbance scores increased in late pregnancy. Importantly, PSQI prospectively predicted increases in depressive symptoms.
  
  
  CONCLUSIONS
  Findings suggest that the PSQI is useful in pregnancy research. Findings also support the idea that sleep problems are prospective risk factors for increases in depressive symptoms during pregnancy. Practitioners are advised to screen for sleep quality during early pregnancy.
authors.affiliation: School of Psychology, Deakin University, Burwood, Victoria, Australia. helens@deakin.edu.au
authors.forename: Helen
authors.initials: H
authors.lastname: Skouteris
authors.forename: Eleanor H
authors.initials: EH
authors.lastname: Wertheim
authors.forename: Carmela
authors.initials: C
authors.lastname: Germano
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Paxton
authors.forename: Jeannette
authors.initials: J
authors.lastname: Milgrom
mesh_terms: D000328:Adult; D015984:Causality; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D010555:Personality Inventory; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000175:diagnosis; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult