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      Relationship between sleep characteristics and depressive symptoms in last trimester of pregnancy

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          Abstract

          Background

          Sleep problems during pregnancy may cause many complications that reduce quality of life.

          Aim

          This study aims to determine the relationship between pregnant women's sleep characteristics and depressive symptoms.

          Methods

          A hospital-based, cross-sectional study was conducted. Pregnant women were selected from the population by using the an improbable random sampling method. This study sample included 436 pregnant women who met the study's inclusion criteria. To collect data, this study used an information form that was developed by the researcher after reviewing relevant literature, the Women's Health Initiative Insomnia Rating Scale (WHIIRS), and the Beck Depression Inventory (BDI). The researchers used face-to-face interviews method to collect data from the participants, pregnant women who were examined in the polyclinic.

          Results

          This study found that 36% of participating pregnant women reported insomnia, and 38.1% experienced depressive symptoms. It also determined that participants who had problems with insomnia, who experienced a change in sleep habits, and who did not wake up feeling rested experienced depressive symptoms 1.64, 2.79, and 2.59 times more than those who didn't have these problems, respectively. who experienced a decrease in sleep, who experienced an increase in sleep, and who did not wake up feeling rested experienced depressive symptoms 1.61, 3.22, 3.53, and 2.59 times more, respectively, than those who did not have insomnia, who did not experience a change in sleep habits in pregnancy, and who woke up feeling rested, respectively.

          Conclusion

          This study determined that there is a relationship between insomnia and depressive symptoms and that pregnant women experiencing insomnia presented with more depressive symptoms.

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          Most cited references35

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          Sleep quality during pregnancy: A meta-analysis

          Women's sleep quality has been reported to change during pregnancy; prevalence estimates of poor sleep quality during pregnancy vary widely. To further understand the observed variation of findings, we conducted a meta-analysis to quantify the prevalence of poor sleep quality during pregnancy. Articles (N = 24) that reported prevalence of poor sleep quality as captured by the Pittsburgh sleep quality index (PSQI) ≥ 5 were included, with a total of 11,002 participants contributing data. PubMed, PsycINFO, and Web of Science databases were systematically searched. Results indicated that the average PSQI score during pregnancy was 6.07, 95% confidence interval (CI) [5.30, 6.85], and 45.7%, 95% CI [36.5%, 55.2%], of pregnant women experienced poor sleep quality. Longitudinal studies indicated that sleep quality decreased from second (M = 5.31, SE = 0.40) to third trimester (M = 7.03, SE = 0.85) by 1.68 points, 95% CI [0.42, 2.94]. Gestational age moderated the average PSQI scores and prevalence of PSQI scores ≥5; older samples reported higher mean PSQI scores and higher prevalence of poor sleep quality. Clinicians should be aware that some reduction in sleep quality is expected during pregnancy, but complaints of very poor sleep quality could require intervention. Future research should examine various factors underlying poor sleep quality during pregnancy.
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            Sleep disturbances in pregnancy.

            To estimate the prevalence and patterns of sleep disturbances during pregnancy among healthy nulliparous women. This was a prospective, cohort study of healthy nulliparous women, recruited between 6 and 20 weeks of gestation, who completed a baseline sleep survey at enrollment with follow-up in the third trimester. The survey was composed of the following validated sleep questionnaires: Berlin Questionnaire for Sleep Disordered Breathing, Epworth Sleepiness Scale, National Institutes of Health/International Restless Legs Syndrome Question Set, Women's Health Initiative Insomnia Rating Scale, and the Pittsburgh Sleep Quality Index. Differences in sleep characteristics between the baseline and third trimester were compared using the paired t test or McNemar test for continuous or categorical data, respectively. One hundred eighty-nine women completed both baseline and follow-up sleep surveys. The mean gestational age was 13.8 (+/-3.8) and 30.0 (+/-2.2) weeks at the first and second surveys, respectively. Compared with the baseline assessment, mean sleep duration was significantly shorter (7.4 [+/-1.2] hours compared with 7.0 [+/-1.3] hours, P<.001), and the proportion of patients who reported frequent snoring (at least three nights per week) was significantly greater (11% compared with 16.4%, P=.03) in the third trimester. The percentage of patients who met diagnostic criteria for restless leg syndrome increased from 17.5% at recruitment to 31.2% in the third trimester (P=.001). Overall poor sleep quality, as defined by a Pittsburgh Sleep Quality Index score greater than 5, became significantly more common as pregnancy progressed (39.0% compared with 53.5%, P=.001). Sleep disturbances are prevalent among healthy nulliparous women and increase significantly during pregnancy. II.
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              Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship?

              Sleep duration in the population has been declining. Women occupy an increasingly prominent place in the work force without reducing most of their responsibilities at home. Consequently, sleep needs are often pushed to the bottom of women's daily priority list. Prior research has indicated that sleep deprivation is associated with higher levels of pro-inflammatory serum cytokines. This is important because higher plasma concentrations of pro-inflammatory serum cytokine levels are associated with postpartum depression and adverse birth outcomes such as preterm delivery. However, little research has directly examined how sleep deprivation may affect maternal and fetal outcomes. This review summarizes the existing data on the effect of sleep deprivation during pregnancy on maternal and fetal outcomes. We review supporting evidence for the hypotheses that sleep deprivation during pregnancy increases the risk of preterm delivery and postpartum depression, and that systemic inflammation is the causal mechanism in the association. Prior research on sleep in pregnancy has been limited by varying data collection methods, subjective self-reported sleep measures, small and non-representative samples, cross-sectional designs; descriptive or non-hypothesis driven studies. Future research with longitudinal study designs is needed to allow examination of the effect of sleep deprivation on adverse maternal and fetal outcomes. (c) 2009 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Afr Health Sci
                Afr Health Sci
                African Health Sciences
                Makerere Medical School (Kampala, Uganda )
                1680-6905
                1729-0503
                December 2019
                : 19
                : 4
                : 2934-2944
                Affiliations
                [1 ] Inonu University, Faculty of Nursing / Department of Birth, Women Health and Illness, 44280 Malatya, Turkey. Fax: +904223410220 GSM: 05534770468. gulcin.nacar@ 123456gmail.com
                [2 ] Inonu University, Faculty of Nursing / Department of Birth, Women Health and Illness, 44280 Malatya, Turkey. Fax: +90 422 3410220 GSM: 05066047909. setimur@ 123456gmail.com
                Author notes
                Corresponding author: Gülçin Nacar, Inonu University, Faculty of Nursing /Department of Birth, Women Health and Illness, 44280 Malatya, Turkey. Fax: +90 422 3410220 GSM: 05534770468 gulcin.nacar@ 123456gmail.com
                Article
                jAFHS.v19.i4.pg2934
                10.4314/ahs.v19i4.14
                7040327
                32127868
                35432993-4580-42e7-bdb1-03be90bfff6b
                © 2019 Nacar et al.

                Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License ( https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                depressions,last trimester,pregnancy,sleep characteristics

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