title: Perceived sleep quality is worse than objective parameters of sleep in pregnant women with a mental disorder.
abstract: OBJECTIVE
  Disturbed sleep during pregnancy is associated with adverse obstetric outcomes and less mental well-being. In pregnant women with a mental disorder, who frequently suffer from sleep problems, it is unknown whether predominantly objective or subjective sleep quality is more affected. To clarify this, we compared objective and subjective parameters of sleep quality between patients and healthy controls during pregnancy.
  
  
  METHODS
  This observational study was embedded in an ongoing study among pregnant women with a mental disorder at the department of Psychiatry of Erasmus University Medical Center Rotterdam, the Netherlands. We compared 21 pregnant women with a confirmed mental disorder with 33 healthy controls (gestational age, 23-29 weeks). To measure objective parameters of sleep quality, all participants continuously wore a wrist actigraph for 7 days and nights. Subjective sleep quality was retrospectively assessed using the Pittsburgh Sleep Quality Index (PSQI) and on a daily basis with the Subjective Sleep Quality-scale (SSQ). Differences in parameters of sleep between patients and controls were tested using a multivariate linear regression analysis adjusted for parity, gestational age, educational level, and employment status.
  
  
  RESULTS
  Objective parameters of sleep quality and subjective sleep quality as assessed by the PSQI did not differ significantly between patients and controls. Daily sleep reports showed that, relative to controls, patients had a significantly worse average SSQ-score (5.2 vs. 7.6, adjusted β = 0.12, 95%CI = 0.03-0.53, p < 0.01).
  
  
  CONCLUSIONS
  Our exploratory study suggests that perceived sleep quality reported on a daily basis by pregnant women with a mental disorder is worse than the sleep quality as measured by wrist actigraphy.
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Leontien M
authors.initials: LM
authors.lastname: Van Ravesteyn
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Joke H M
authors.initials: JH
authors.lastname: Tulen
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Astrid M
authors.initials: AM
authors.lastname: Kamperman
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Monique E
authors.initials: ME
authors.lastname: Raats
authors.affiliation: Department of Obstetrics and Gynaecology, subdivision of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: A J Tom
authors.initials: AJ
authors.lastname: Schneider
authors.affiliation: Institute of Health Management and Policy, Erasmus University, Rotterdam, the Netherlands.
authors.forename: Erwin
authors.initials: E
authors.lastname: Birnie
authors.affiliation: Department of Obstetrics and Gynaecology, subdivision of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Witte J G
authors.initials: WJ
authors.lastname: Hoogendijk
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Henning W
authors.initials: HW
authors.lastname: Tiemeier
authors.affiliation: Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands ; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Mijke P
authors.initials: MP
authors.lastname: Lambregtse-van den Berg
mesh_terms: D056044:Actigraphy / Q000379:methods; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D010465:Perception; D011247:Pregnancy; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012959:Socioeconomic Factors
keywords: actigraphy; mental disorder; pregnancy; sleep quality