Kember Allan J, Elangainesan Praniya, Ferraro Zachary M, Jones Claire, Hobson Sebastian R
Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Front Med (Lausanne). 2023 Aug 21;10:1235252. doi: 10.3389/fmed.2023.1235252. eCollection 2023.
In this review, we provide a comprehensive overview of common sleep disorders during pregnancy, including their characterization, prevalence, risk factors, and possible contribution to maternal and fetal outcomes. We conducted a quasi-systematic literature search of the MEDLINE database and identified 744 studies from 1991 through 2021, inclusive, that met our inclusion criteria. We synthesized the existing literature on sleep disorders during pregnancy and highlighted controversies, research gaps, and needed clinical developments. Our review covers a range of sleep disorders, including insomnia, obstructive sleep apnea, restless legs syndrome, and circadian rhythm disorders. We discuss the prevalence of these disorders in pregnancy and their potential impact on maternal and fetal health outcomes. We also explore the relationship between sleep disorders, pre-pregnancy comorbidities such as obesity, and pregnancy-related conditions such as gestational diabetes mellitus and preeclampsia. In addition to summarizing the existing literature on sleep disorders during pregnancy, we also highlight opportunities for further research in this area. We suggest that future studies should strive to employ validated and objective measurement tools for sleep disorders and prioritize utilization of longitudinal methods with participant follow-up through postpartum, mid-life, menopause, and beyond. We also put forward investigation into the impact of circadian rhythm disruption on reproductive physiology and early pregnancy outcomes as an area of important work. Overall, our review provides valuable insights on sleep and reproduction and into common sleep disorders during pregnancy and their potential impact on maternal and fetal health outcomes.
在本综述中,我们全面概述了孕期常见的睡眠障碍,包括其特征、患病率、危险因素以及对母婴结局的可能影响。我们对MEDLINE数据库进行了半系统的文献检索,确定了1991年至2021年(含)期间符合我们纳入标准的744项研究。我们综合了关于孕期睡眠障碍的现有文献,突出了争议、研究空白以及所需的临床进展。我们的综述涵盖了一系列睡眠障碍,包括失眠、阻塞性睡眠呼吸暂停、不安腿综合征和昼夜节律障碍。我们讨论了这些障碍在孕期的患病率及其对母婴健康结局的潜在影响。我们还探讨了睡眠障碍、孕前合并症(如肥胖)以及与妊娠相关的疾病(如妊娠期糖尿病和先兆子痫)之间的关系。除了总结孕期睡眠障碍的现有文献外,我们还强调了该领域进一步研究的机会。我们建议未来的研究应努力采用经过验证的客观睡眠障碍测量工具,并优先利用纵向研究方法,对参与者进行产后、中年、绝经及以后的随访。我们还提出,将昼夜节律紊乱对生殖生理和早期妊娠结局的影响作为一个重要的研究领域进行调查。总体而言,我们的综述为睡眠与生殖以及孕期常见睡眠障碍及其对母婴健康结局的潜在影响提供了有价值的见解。