University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA 15213, USA.
University of Pittsburgh, Graduate School of Public Health, Epidemiology Data Center, Pittsburgh, PA 15213, USA.
Sleep Med. 2014 Apr;15(4):444-50. doi: 10.1016/j.sleep.2014.01.003. Epub 2014 Feb 8.
Cardiometabolic (CM) risk factors are linked to increased morbidity. Disturbed sleep is associated with CM risk factors in late pregnancy, but little is known about sleep in early pregnancy and CM risk factors.
Diary and actigraphy-assessed sleep information, as well as CM outcomes (blood pressure (BP) and body mass index (BMI)), were collected thrice from pregnant women (N=161) in early pregnancy: T1 (10-12 weeks), T2 (14-16 weeks) and T3 (18-20 weeks). The sleep variables evaluated included sleep onset latency (SOL), wake after sleep onset (WASO) and total sleep time (TST). Sleep variables were dichotomised using established clinical cut-offs.
BMI and BP significantly changed across time. Women with persistent SOL≥20 min had greater BMI than women without persistent SOL≥20 min prior to covariate adjustment at T1 and T2, but at T3 the BMI values converged. Similar results were observed for persistent WASO≥30 min. Persistently long WASO, as measured by actigraphy, was associated with elevated SBP, after controlling for covariates.
Consistent with anecdotal evidence, it appears as if a subset of women report substantial difficulty initiating and maintaining sleep during early pregnancy and this may augment the risk of higher BP and BMI. Understanding these relationships is important as CM risk factors are linked to maternal and infant morbidity. Assessing sleep in early pregnancy may bestow time necessary for appropriate intervention.
心脏代谢（CM）危险因素与发病率增加有关。睡眠紊乱与妊娠晚期的 CM 危险因素有关，但关于妊娠早期的睡眠与 CM 危险因素知之甚少。
通过日记和活动记录仪评估的睡眠信息以及 CM 结局（血压（BP）和体重指数（BMI））在妊娠早期（T1：10-12 周；T2：14-16 周；T3：18-20 周）三次从孕妇（N=161）中收集。评估的睡眠变量包括入睡潜伏期（SOL）、睡眠后觉醒（WASO）和总睡眠时间（TST）。使用既定的临床截止值将睡眠变量分为两类。
BMI 和 BP 随时间显著变化。在调整协变量之前，在 T1 和 T2 时，持续 SOL≥20 分钟的女性 BMI 大于没有持续 SOL≥20 分钟的女性，但在 T3 时 BMI 值趋于一致。对于持续 WASO≥30 分钟也观察到类似的结果。通过活动记录仪测量的持续长 WASO与 SBP 升高相关，在控制了协变量之后。
与传闻证据一致，似乎有一部分女性报告在妊娠早期有相当大的入睡和维持睡眠的困难，这可能会增加高血压和 BMI 升高的风险。了解这些关系很重要，因为 CM 危险因素与母婴发病率有关。评估妊娠早期的睡眠可能会提供必要的干预时间。
