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What is "normal"?: an examination of sleep continuity & sleep morbidities amongst pregnant women, women who are intending to conceive, and women who are not intending to conceive
Thesis   Open access

What is "normal"?: an examination of sleep continuity & sleep morbidities amongst pregnant women, women who are intending to conceive, and women who are not intending to conceive

Alison R. Hartman
Master of Science (M.S.), Drexel University
Feb 2021
DOI:
https://doi.org/10.17918/00000543
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Abstract

Pregnant women Infertility Pregnancy Psychology Sleep Disorders
Maternal sleep disturbance is common during pregnancy. Some sleep disturbances that accompany pregnancy, such as increased sleep fragmentation due to pregnancy-related bodily discomfort, are normative. These normative sleep disturbances may be attributable to physical, hormonal, or psychological changes that occur during pregnancy. Other sleep problems that arise during this transitional time, however, may pose a risk for insomnia disorder, psychopathology such as depression and anxiety, and adverse pregnancy, maternal health, infant health, and birth outcomes. This important distinction between normative, expected sleep difficulties and non-normative, maladaptive sleep problems that may confer risk has yet to be defined amongst women who are pregnant. Furthermore, there is a paucity of research examining sleep continuity or sleep morbidities (disorders) amongst women who are intending to conceive, including those who are experiencing infertility and therefore are likely to be highly stressed. This research aimed to address these gaps by providing a comprehensive view of sleep continuity and sleep morbidities amongst women of reproductive age across childbearing status. The current study utilized a prospective cohort design to examine sleep continuity and sleep morbidities cross-sectionally amongst three groups of reproductive-aged nulliparous women: those who, at the time of enrollment, were 1) not currently intending to conceive, 2) currently intending to conceive (including those with infertility), and 3) currently in the first trimester of pregnancy. Participants self-reported demographic data, sleep continuity data, and sleep morbidity data utilizing an online questionnaire and daily sleep diaries. Results indicated that, across childbearing status, reproductive-aged women experienced more sleep disturbances than suggested by population norms. Compared to those who were not intending to conceive and those who were intending to conceive, pregnant women in the first trimester reported higher cumulative sleep morbidity. Specifically, pregnant women were found to be at increased risk for symptoms of insomnia disorder and restless legs syndrome compared to their peers. Pregnant women were more likely to report symptoms of early, middle, and late insomnia than their peers, resulting in increased daytime fatigue in this population. Finally, women with a perceived problem becoming pregnant, regardless of meeting clinical criteria for infertility or undergoing fertility treatment, experienced increased insomnia symptoms. This research has the potential to impact how providers characterize normal versus abnormal sleep amongst women of various childbearing statuses, and thereby may contribute to improved pregnancy and maternal/infant health outcomes.

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