Sleep in pregnancy quarters: a longitudinal study

This is a longitudinal, with three follow-up periods at each gestational trimester (called T1, T2 and T3). Fifty (50) pregnant women without comorbidities started the study. The following instruments were used: sociodemographic and clinical characterization, Pittsburgh Sleep Quality Index and Sleep Diary. Data were analyzed using statistical tests (Chi-square, non-parametric tests and regression models).

Results:

We identified that 55.3% of the pregnant women reported sleep disorders in T1, 39.5% in T2, and 65.8% in T3; in T3, the risk of reporting sleep problems increased by 67% in comparison with T2.

Conclusion:

Considering the high prevalence of poor-quality sleep, especially in the third trimester, prenatal care is understood as a moment of intense learning and an opportunity for nurses to develop actions concerning education, guidance and sleep hygiene.

Keywords:
Sleep; Pregnant women; Nursing

Gestational trimesters	Risks Ratio	95% CI LI - LS	p-value
Second vs. first trimester	0.71	0.50 - 1.01	0.059
Third vs. first trimester	1.19	0.89 -1.60	0.249
Third vs. second trimester	1.67	1.08 - 2.56	0.019

Variable	Trimester	Average (SD)	Median	Minimum	Maximum	p-value
Sleep duration (hours)	1st	9.2 (1.2)	9.3	5.7	12.0	0.1307
	2nd	9.0 (1.3)	8.8	4.7	11.2
	3rd	8.8 (1.3)	8.5	4.7	12.5
Sleep latency (minutes)	1st	19.7 (24.0)	12.9	0.0	102.9	0.1792
	2nd	15.9 (21.3)	9.5	0.0	94.3
	3rd	16.6 (21.6)	7.5	0.0	94.3
Awakenings during sleep (number)	1st	1.5 (0.9)	1.6	0.0	3.9	0.013
	2nd	1.7 (1.0)	1.7	0.0	4.4
	3rd	2.1 (1.4)	2.1	0.0	5.2
Naps (number)	1st	0.4 (0.4)	0.4	0.0	1.1	0.4405
	2nd	0.3 (0.4)	0.2	0.0	1.8
	3rd	0.4 (0.4)	0.3	0.0	1.8
PSQI-BR (total score)	1st	6.3 (2.9)	6.0	3.0	16.0	0.0018
	2nd	7.0 (3.0)	4.5	2.0	14.0
	3rd	7.2 (3.4)	6.0	3.0	13.0
Component 1: Sleep Quality	1st	0.9 (0.6)	1.0	0.0	3.0	0.004
	2nd	1.0 (0.6)	1.0	0.0	2.0
	3rd	1.5 (0.8)	1.0	0.0	3.0
Component 2 Sleep latency	1st	1.4 (0.9)	1.0	0.0	3.0	0.0825
	2nd	0.9 (1.0)	1.0	0.0	3.0
	3rd	1.1 (1.0)	1.0	0.0	3.0
Component 3: Sleep Duration	1st	0.5 (0.7)	0.0	0.0	3.0	0.0279
	2nd	0.3 (0.5)	0.0	0.0	1.0
	3rd	0.6 (1.0)	0.0	0.0	3.0
Component 4: Sleep efficiency	1st	0.4 (0.7)	0.0	0.0	3.0	0.0743
	2nd	0.2 (0.6)	0.0	0.0	3.0
	3rd	0.4 (0.7)	0.0	0.0	3.0
Component 5: Sleep Disorders	1st	1.2 (0.5)	1.0	0.0	3.0	0,0907
	2nd	1.2 (0.4)	1.0	1.0	2.0
	3rd	1,4 (0,6)	1.0	1.0	3.0
Component 7: Daytime Dysfunction	1st	1.9 (1.0)	2.0	0.0	3.0	0.0110
	2nd	1.5 (0.9)	2.0	0.0	3.0
	3rd	2.0 (1.1)	2.0	0.0	3.0

Variable	Pregnant women with sleep disorders according to the Pittsburg Sleep Quality Index (PSQI-BR)
	1st trimester			2nd trimester			3rd trimester
	n	%	p-value	n	%	p-value	n	%	p-value
Marital status
Without partner	2	40.0	0.6396	1	20.0	0,6295	3	60.0	1.000
With partner	19	57.6		14	42.4		22	66.7
Paid Activity
No	13	62.0	0.3601	8	38.1	0.8468	17	80.9	0.0285
Yes	8	47.1		7	41.2		8	47.1
Feel pain
No / Sporadically	15	55.6	1,0000	9	31.0	0.1154	9	60,0	0.5435
Every day	6	54.5		6	66.7		16	69.6
Planned pregnancy
No	11	52.4	0.6913	9	42.9	0.6353	15	71.4	0.4154
Yes	10	58.8		6	35.3		10	58.8
Receives support
No/Little	10	66.7	0.2536	7	46.7	0.4638	9	60.0	0.5435
Very much	11	47.8		8	34.8		16	69.6
Type of delivery
Normal	12	52.2	0.6353	5	21.7	0.0056	13	56.5	0.1359
Cesarean section	9	60.0		10	66.7		12	80.0

Factors present in the first trimester	Categories	Risks Ratio	95% CI		p-value
Factors present in the first trimester	Categories	Risks Ratio	LI	LS	p-value
Age of pregnant women (In years)	-	1.01	0.97	1.05	0.5769
Marital status	Have no partner	-	-	-	0.3267
	Have a partner	1.44	0.70	2.97
Paid Activity	No (ref.)	-	-	-	0.5025
	Yes	0.85	0.54	1.35
Feel pain	No/sporadically (ref.)	-	-	-	0.0704
	Every day	1.33	0.98	1.82
Planned pregnancy	No (ref.)	-	-	-	0.5691
	Yes	0.87	0.53	1.41
Support	No (ref.)	-	-	-	0.5291
	Very much	0.88	0.60	1.30
Sleep Duration (trimester average)	-	1.01	1.00	1.01	0.1881

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Natália Amorim Ramos Felix E-mail: natalia_amorim_ramos@yahoo.com.br