title: Prevalence of sleep deficiency in early gestation and its associations with stress and depressive symptoms.
abstract: OBJECTIVE
  Sleep deficiency is an emerging concept denoting a deficit in the quantity or quality of sleep. This may be particularly salient for pregnant women since they report considerable sleep complaints. Sleep deficiency is linked with morbidity, including degradations in psychosocial functioning, (e.g., depression and stress), which are recognized risk factors for adverse pregnancy outcomes. We sought to describe the frequency of sleep deficiency across early gestation (10-20 weeks) and whether sleep deficiency is associated with reports of more depressive symptoms and stress.
  
  
  METHODS
  Pregnant women (N=160) with no self-reported sleep or psychological disorder provided sleep data collected via diary and actigraphy during early pregnancy: 10-12, 14-16, and 18-20 weeks' gestation. Sleep deficiency was defined as short sleep duration, insufficient sleep, or insomnia. Symptoms of depression and stress were collected at the same three time points. Linear mixed effects models were used to analyze the data.
  
  
  RESULTS
  Approximately 28%-38% met criteria for sleep deficiency for at least one time point in early gestation. Women who were sleep deficient across all time points reported more perceived stress than those who were not sleep deficient (p<0.01). Depressive symptoms were higher among women with diary-defined sleep deficiency across all time points (p=0.02).
  
  
  CONCLUSIONS
  Sleep deficiency is a useful concept to describe sleep recognized to be disturbed in pregnancy. Women with persistent sleep deficiency appear to be at greater risk for impairments in psychosocial functioning during early gestation. These associations are important since psychosocial functioning is a recognized correlate of adverse pregnancy outcomes. Sleep deficiency may be another important risk factor for adverse pregnancy outcomes.
authors.affiliation: 1 Department of Psychiatry, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Okun
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Kline
authors.forename: James M
authors.initials: JM
authors.lastname: Roberts
authors.forename: Barbara
authors.initials: B
authors.lastname: Wettlaufer
authors.forename: Khaleelah
authors.initials: K
authors.lastname: Glover
authors.forename: Martica
authors.initials: M
authors.lastname: Hall
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D037841:Pregnant People; D015995:Prevalence; D012307:Risk Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology