Warland Jane, Dorrian Jillian
School of Nursing and Midwifery, University of South Australia, Adelaide, Australia.
School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia; Centre for Sleep Research, University of South Australia, Adelaide, Australia.
PLoS One. 2014 Dec 23;9(12):e115760. doi: 10.1371/journal.pone.0115760. eCollection 2014.
There is emerging research to suggest that supine maternal sleep position in late pregnancy may adversely affect fetal wellbeing. However, these studies have all been based on maternal report of sleeping position. Before recommendations to change sleep position can be made it is important to determine the validity of these studies by investigating how accurate pregnant women are in reporting their sleep position. If avoiding the supine sleeping position reduces risk of poor pregnancy outcome, it is also important to know how well women can comply with the instruction to avoid this position and sleep on their left.
Thirty women in late pregnancy participated in a three-night observational study and were asked to report their sleeping position. This was compared to sleep position as recorded by a night capable video recording. The participants were instructed to settle to sleep on their left side and if they woke overnight to settle back to sleep on their left.
There was a moderate correlation between reported and video-determined left-side sleep time (r = 0.48), mean difference = 3 min (SD = 3.5 h). Participants spent an average of 59.60% (SD = 16.73%) of time in bed on their left side (ICC across multiple nights = 0.67). Those who included left side among their typical sleep positions reported significantly longer sleep during the study (p<0.01).
On average participant reports of sleep position were relatively accurate but there were large individual differences in reporting accuracy and in objectively-determined time on left side. Night-to-night consistency was substantial. For those who do not ordinarily sleep on that side, asking participants to sleep on their left may result in reduced sleep duration. This is an important consideration during a sleep-critical time such as late pregnancy.
越来越多的研究表明,妊娠晚期孕妇仰卧睡眠姿势可能会对胎儿健康产生不利影响。然而,这些研究均基于孕妇对睡眠姿势的报告。在提出改变睡眠姿势的建议之前,通过调查孕妇报告睡眠姿势的准确性来确定这些研究的有效性很重要。如果避免仰卧睡眠姿势可降低不良妊娠结局的风险,那么了解女性遵守避免此姿势并左侧卧位睡眠的指示的程度也很重要。
30名妊娠晚期女性参与了一项为期三晚的观察性研究,并被要求报告她们的睡眠姿势。将其与夜间视频记录的睡眠姿势进行比较。参与者被指示左侧卧位入睡,如果夜间醒来则继续左侧卧位入睡。
报告的左侧卧位睡眠时间与视频确定的左侧卧位睡眠时间之间存在中等程度的相关性(r = 0.48),平均差异为3分钟(标准差 = 3.5小时)。参与者平均在床上左侧卧位的时间为59.60%(标准差 = 16.73%)(多晚的组内相关系数 = 0.67)。那些将左侧卧位作为其典型睡眠姿势之一的参与者在研究期间报告的睡眠时间明显更长(p<0.01)。
平均而言,参与者对睡眠姿势的报告相对准确,但在报告准确性和客观确定的左侧卧位时间方面存在较大个体差异。夜间一致性较高。对于那些平时不习惯于该侧卧位睡眠的人,要求他们左侧卧位睡眠可能会导致睡眠时间减少。在妊娠晚期这种对睡眠至关重要的时期,这是一个重要的考虑因素。