title: Factors associated with clinically significant insomnia among pregnant low-income Latinas.
abstract: BACKGROUND
  Poor sleep, common during pregnancy, is associated with negative health risks. The study aimed to identify predictors of clinically significant insomnia among pregnant Latinas.
  
  
  METHODS
  A total of 1289 pregnant Latinas recruited from obstetric clinics completed the Insomnia Severity Index (ISI) and questions about demographics and sleep.
  
  
  RESULTS
  Clinically significant insomnia (ISI≥10) was present among 17% of participants. Significant correlates of clinically significant insomnia were higher scores on the Edinburgh Postnatal Depression Scale (EPDS) after removing the sleep item (47% of women with EPDS≥9 and 9% with EPDS<9), completing measures in English (rather than Spanish: 26% versus 13%), and income but not pregnancy week, age, highest education level, or marital status. The highest percentage of clinically significant insomnia (59%) was experienced by women with EPDS≥9 who completed measures in English. The lowest percentage of clinically significant insomnia (6.2%) was experienced by women with EPDS<9 who completed measures in Spanish.
  
  
  CONCLUSIONS
  In this sample of low-income, mostly Spanish-speaking pregnant Latinas, rates of clinically significant insomnia appear to be higher than rates among nonpregnant Latinas. Rates of clinically significant insomnia are particularly high among Latinas with elevated depressive symptom severity, a known risk for insomnia. Acculturation, as indicated by completing measures in English, may be another risk specific to Latinas, possibly owing to loss of some ethnicity-specific protective factors (e.g., social support, strong family ties, and group identity). It will be important to directly test this explanation in future research.
authors.affiliation: Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA 94301-5597, USA. rmanber@stanford.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Manber
authors.forename: Dana
authors.initials: D
authors.lastname: Steidtmann
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Chambers
authors.forename: William
authors.initials: W
authors.lastname: Ganger
authors.forename: Sarah
authors.initials: S
authors.lastname: Horwitz
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Connelly
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007802:Language; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D011263:Pregnancy Trimester, Third; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000208:ethnology* / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires