title: Low socioeconomic status negatively affects sleep in pregnant women.
abstract: OBJECTIVE
  To evaluate the effect of socioeconomic status on measures of sleep quality, continuity, and quantity in a large cohort of pregnant women.
  
  
  METHODS
  Prospective, longitudinal study.
  
  
  METHODS
  One hundred seventy (170) pregnant women at 10-20 weeks gestation.
  
  
  METHODS
  Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Sleep duration and continuity (sleep fragmentation index [SFI]) were assessed with actigraphy at 10-12, 14-16, and 18-20 weeks gestation. Because sleep did not significantly differ across time, averages across all three time points were used in analyses. Socioeconomic status (SES) was defined by self-reported annual household income. Linear regression analyses were used to model the independent associations of SES on sleep after adjusting for age, race, parity, marital status, body mass index (BMI), perceived stress, depressive symptoms, and financial strain.
  
  
  RESULTS
  On average, women reported modestly poor sleep quality (M = 5.4, SD = 2.7), short sleep duration (391 [55.6] min) and fragmented sleep (SFI M = 33.9, SD = 10.4. A household income < $50,000/year was associated with poorer sleep quality (β = -.18, p < 0.05) and greater sleep fragmentation (β = -.18, p < 0.05) following covariate adjustment.
  
  
  CONCLUSIONS
  Low SES was associated with poorer sleep quality and fragmented sleep, even after statistical adjustments. Perceived stress and financial strain attenuated SES-sleep associations indicating that psychosocial situations preceding pregnancy are also important to consider.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Okun
authors.forename: Madeline
authors.initials: M
authors.lastname: Tolge
authors.forename: Martica
authors.initials: M
authors.lastname: Hall
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007182:Income; D016014:Linear Models; D008137:Longitudinal Studies; D017286:Polysomnography; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D055815:Young Adult
keywords: SES; actigraphy; education; income; pregnancy; sleep; stress