title: Non-pharmacological interventions for sleep quality and insomnia during pregnancy: A systematic review.
abstract: OBJECTIVE
  To systematically review the literature regarding non-pharmacological inteventions for improving sleep quality and insomnia during pregnancy.
  
  
  METHODS
  An electronic search strategy was conducted using several online databases (CINAHL, PubMed, Medline, Index to Chiropractic Literature) from inception to March 2013. Inclusion criteria consisted of studies evaluating non-pharmacological interventions, published in English in a peer reviewed journal, and assessed sleep quality or insomnia. The full text of suitable articles was reviewed by the authors, and scored using a risk of bias assessment.
  
  
  RESULTS
  160 articles were screened and seven studies met the inclusion criteria in the form of three prospective RCTs, one prospective longitudinal trial, one experimental pilot study, and two prospective quasi-randomized trials. Quality scores ranged from five to eight out of twelve on the risk of bias scoring criteria.
  
  
  CONCLUSIONS
  Exercise, massage, and acupuncture may be associated with improved sleep quality during pregnancy, however, due to the low quality and heterogeneity of the studies yielded, a definitive recommendation cannot be made. Further higher quality research is indicated.
authors.affiliation: Institution: Canadian Memorial Chiropractic College, Division of Graduate Education & Research.
authors.forename: Dana
authors.initials: D
authors.lastname: Hollenbach
authors.forename: Riley
authors.initials: R
authors.lastname: Broker
authors.forename: Stacia
authors.initials: S
authors.lastname: Herlehy
authors.forename: Kent
authors.initials: K
authors.lastname: Stuber
keywords: insomnia; interventions; quality; sleep