Evagorou Olympia, Arvaniti Aikaterini, Plakias Spyridon, Koutlaki Nikoleta, Katsikidou Magdalini, Sfelinioti Sofia, Steiropoulos Paschalis, Samakouri Maria
Department of Psychiatry, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
Department of Physical Education and Sports, University of Thessaly, 42100 Trikala, Greece.
J Clin Med. 2025 Sep 6;14(17):6310. doi: 10.3390/jcm14176310.
: Sleep plays a key role in female fertility. Sleep disturbances (SDis) during pregnancy are common and may negatively affect maternal health, contributing to an increased risk of perinatal depression and anxiety. : The present prospective study aimed to examine the interplay of sleep, anxiety, and depression during the pregnancy and postpartum stages, comparing women who conceived naturally (NC) with those who conceived through assisted reproductive treatment (ART). : The study included five timepoints: pre-pregnancy (t0), the end of each trimester (t1-t3), and the postpartum period (t4). SDis were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Fatigue Severity Scale (FFS); perinatal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Demographic and clinical characteristics were also collected. Given the imbalance in group size and the dispersion of values, a negative binomial regression model with robust variances and Satterthwaite approximation for the degrees of freedom was applied. : Compared to women with NC (N = 37), those undergoing ART (N = 57) were more likely to be older ( < 0.001), married ( < 0.001), unemployed ( < 0.001), and have a history of thyroid disease ( = 0.008). Significant differences between different time points were observed in both NC (N = 37) and successfully conceived ART groups (N = 9) in all sleep, fatigue, and well-being parameters. Notably, at the end of the first trimester (t1), the ART group reported more severe insomnia symptoms ( = 0.02). : SDis are common in pregnancy, but more pronounced during the first trimester among women on ART. These findings highlight the need for early screening and targeted psychological support during perinatal care.
睡眠在女性生育能力中起着关键作用。孕期睡眠障碍（SDis）很常见，可能会对孕产妇健康产生负面影响，增加围产期抑郁和焦虑的风险。本前瞻性研究旨在探讨孕期和产后阶段睡眠、焦虑和抑郁之间的相互作用，比较自然受孕（NC）的女性与通过辅助生殖治疗（ART）受孕的女性。该研究包括五个时间点：孕前（t0）、每个孕期结束时（t1 - t3）和产后阶段（t4）。使用匹兹堡睡眠质量指数（PSQI）、雅典失眠量表（AIS）、爱泼华嗜睡量表（ESS）、疲劳严重程度量表（FFS）评估睡眠障碍；使用爱丁堡产后抑郁量表（EPDS）评估围产期抑郁和焦虑症状。还收集了人口统计学和临床特征。鉴于组间大小不平衡和值的离散性，应用了具有稳健方差和自由度的萨特思韦特近似的负二项回归模型。与自然受孕的女性（N = 37）相比，接受辅助生殖治疗的女性（N = 57）年龄更大（<0.001）、已婚（<0.001）、失业（<0.001）且有甲状腺疾病史（=0.008）。在自然受孕组（N = 37）和成功受孕的辅助生殖治疗组（N = 9）中，在所有睡眠、疲劳和幸福感参数的不同时间点之间均观察到显著差异。值得注意的是，在孕早期结束时（t1），辅助生殖治疗组报告的失眠症状更严重（=0.02）。睡眠障碍在孕期很常见，但在接受辅助生殖治疗的女性的孕早期更为明显。这些发现凸显了围产期护理中早期筛查和针对性心理支持的必要性。
