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孕妇的睡眠障碍、抑郁症状及日间嗜睡情况

Sleep Disturbances and Symptoms of Depression and Daytime Sleepiness in Pregnant Women.

作者信息

Tsai Shao-Yu, Lin Jou-Wei, Wu Wei-Wen, Lee Chien-Nan, Lee Pei-Lin

机构信息

School of Nursing, National Taiwan University, Taipei, Taiwan.

Department of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Birth. 2016 Jun;43(2):176-83. doi: 10.1111/birt.12215. Epub 2016 Jan 18.

Abstract

BACKGROUND

Sleep disturbance, depression, and daytime sleepiness are among the most prevalent symptoms reported by women during pregnancy. However, available data on the association between sleep disturbances and symptoms of depression and daytime sleepiness in pregnant women are sparse and methodological limitations have been acknowledged. The purpose of the study was to examine objective and self-reported sleep disturbances and symptoms of depression and daytime sleepiness in a group of healthy pregnant women.

METHODS

A total of 274 third-trimester pregnant women wore a wrist actigraph continuously for 7 days to assess objective sleep quality and quantity. Self-reported sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), with self-reported poor sleep quality defined as a PSQI score more than 5. The Center for Epidemiologic Studies-Depression Scale (CES-D) and Epworth Sleepiness Scale were used to evaluate symptoms of depression and daytime sleepiness, respectively.

RESULTS

Sixty-four (23.4%) women were at risk for clinical depression and 69 (25.2%) had daytime sleepiness. Risk of clinically meaningful depressive symptomatology was significantly increased in women with objective total nighttime sleep less than 6 hours (OR 2.53 [95% CI 1.26-5.08]) and self-reported poor sleep quality (OR 3.31 [95% CI 1.74-6.30]), even after multiple adjustment. Neither objective nor self-reported sleep disturbances increased daytime sleepiness in this group of pregnant women.

DISCUSSION

Both objective nighttime sleep less than 6 hours and self-reported poor sleep quality in healthy third-trimester pregnant women is associated with significant risks for clinical depression. Improving sleep would likely be associated with a reduction in depression symptom severity and an attenuation of the prevalence of depression in pregnant women.

摘要

背景

睡眠障碍、抑郁和日间嗜睡是孕期女性报告的最常见症状。然而,关于孕妇睡眠障碍与抑郁症状及日间嗜睡之间关联的现有数据稀少,且方法学上的局限性已得到认可。本研究的目的是检查一组健康孕妇的客观和自我报告的睡眠障碍以及抑郁症状和日间嗜睡情况。

方法

总共274名孕晚期孕妇连续7天佩戴腕部活动记录仪,以评估客观睡眠质量和数量。通过匹兹堡睡眠质量指数(PSQI)评估自我报告的睡眠质量,自我报告的睡眠质量差定义为PSQI得分超过5分。分别使用流行病学研究中心抑郁量表(CES-D)和爱泼华嗜睡量表评估抑郁症状和日间嗜睡情况。

结果

64名(23.4%)女性有临床抑郁风险,69名(25.2%)有日间嗜睡。即使经过多重调整,客观夜间总睡眠时间少于6小时的女性(比值比2.53 [95%置信区间1.26 - 5.08])和自我报告睡眠质量差的女性(比值比3.31 [95%置信区间1.74 - 6.30])出现具有临床意义的抑郁症状的风险显著增加。在这组孕妇中,客观和自我报告的睡眠障碍均未增加日间嗜睡。

讨论

健康孕晚期孕妇客观夜间睡眠时间少于6小时以及自我报告睡眠质量差均与临床抑郁的显著风险相关。改善睡眠可能会降低孕妇抑郁症状的严重程度并降低抑郁患病率。

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