title: Daily sleep and fatigue characteristics in nulliparous women during the third trimester of pregnancy.
abstract: OBJECTIVE
  To examine the association among nighttime sleep and daytime napping behaviors, depressive symptoms, and perception of fatigue in pregnant women.
  
  
  METHODS
  A prospective descriptive study with within-subject design.
  
  
  METHODS
  A university-affiliated hospital and participants' home environments.
  
  
  METHODS
  Thirty-eight third trimester nulliparous women completed sleep and depressive symptom questionnaires, wore a wrist actigraphy monitor for 7 consecutive days, and kept a concurrent diary reporting naps and rating their level of fatigue using a 0-10 visual analogue scale each morning, midday, afternoon, and evening. A generalized estimating equation regression model was applied to evaluate the time-dependent association.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Mean duration of total nighttime sleep by actigraphy was 386.3 ± 60.7 min, with 11 (28.9%) women having an average total nighttime sleep < 6 h. Nineteen women (50%) napped > 3 days, and only 2 women did not nap over the entire week. Antecedent night sleep duration had a significant inverse association with morning (P = 0.022) and afternoon fatigue (P = 0.009) of the subsequent day. Self-reported naps were significantly associated with midday fatigue (P = 0.003). More depressive symptoms predicted more severe fatigue throughout the day.
  
  
  CONCLUSIONS
  Results suggest that interventions designed to increase sleep duration and decrease depressive symptoms have the potential to prevent, ameliorate, or reduce fatigue in pregnant women. Depressive symptoms during pregnancy likely share some psychological and behavioral tendencies with fatigue and/or sleep disturbance which may complicate the evaluation of intervention effect.
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan. stsai@ntu.edu.tw
authors.forename: Shao-Yu
authors.initials: SY
authors.lastname: Tsai
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
authors.forename: Lu-Ting
authors.initials: LT
authors.lastname: Kuo
authors.forename: Karen A
authors.initials: KA
authors.lastname: Thomas
mesh_terms: D056044:Actigraphy; D000328:Adult; D003866:Depressive Disorder / Q000150:complications; D005221:Fatigue / Q000150:complications*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires