title: Sleep Disturbances and Symptoms of Depression and Daytime Sleepiness in Pregnant Women.
abstract: Sleep disturbance, depression, and daytime sleepiness are among the most prevalent symptoms reported by women during pregnancy. However, available data on the association between sleep disturbances and symptoms of depression and daytime sleepiness in pregnant women are sparse and methodological limitations have been acknowledged. The purpose of the study was to examine objective and self-reported sleep disturbances and symptoms of depression and daytime sleepiness in a group of healthy pregnant women.
  
  
  
  A total of 274 third-trimester pregnant women wore a wrist actigraph continuously for 7 days to assess objective sleep quality and quantity. Self-reported sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), with self-reported poor sleep quality defined as a PSQI score more than 5. The Center for Epidemiologic Studies-Depression Scale (CES-D) and Epworth Sleepiness Scale were used to evaluate symptoms of depression and daytime sleepiness, respectively.
  
  
  
  Sixty-four (23.4%) women were at risk for clinical depression and 69 (25.2%) had daytime sleepiness. Risk of clinically meaningful depressive symptomatology was significantly increased in women with objective total nighttime sleep less than 6 hours (OR 2.53 [95% CI 1.26-5.08]) and self-reported poor sleep quality (OR 3.31 [95% CI 1.74-6.30]), even after multiple adjustment. Neither objective nor self-reported sleep disturbances increased daytime sleepiness in this group of pregnant women.
  
  
  
  Both objective nighttime sleep less than 6 hours and self-reported poor sleep quality in healthy third-trimester pregnant women is associated with significant risks for clinical depression. Improving sleep would likely be associated with a reduction in depression symptom severity and an attenuation of the prevalence of depression in pregnant women.
authors.affiliation: School of Nursing, National Taiwan University, Taipei, Taiwan.
authors.forename: Shao-Yu
authors.initials: SY
authors.lastname: Tsai
authors.affiliation: Department of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
authors.affiliation: Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan.
authors.forename: Chien-Nan
authors.initials: CN
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, National Taiwan University, Taipei, Taiwan.|Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan.|Division of Pulmonary and Critical Care Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Pei-Lin
authors.initials: PL
authors.lastname: Lee
mesh_terms: D056044:Actigraphy; D000328:Adult; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011263:Pregnancy Trimester, Third; D037841:Pregnant People / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
keywords: actigraphy; daytime sleepiness; depression; pregnancy; sleep