Research Report
Nighttime Sleep, Daytime Napping, and Labor Outcomes in Healthy Pregnant Women in Taiwan
Shao-Yu Tsai,
Jou-Wei Lin,
Lu-Ting Kuo,
Chien-Nan Lee,
Carol A. Landis,
Corresponding Author
Shao-Yu Tsai
Department of Nursing, National Taiwan University, No. 1, Sec 1, Jen-Ai Rd, Taipei, 10051 Taiwan
Assistant Professor.Correspondence to Shao-Yu TsaiSearch for more papers by this authorJou-Wei Lin
Department of Medicine, National Taiwan University, Taipei, Taiwan
Associate Professor.Search for more papers by this authorLu-Ting Kuo
Department of Surgery, National Taiwan University, Taipei, Taiwan
Assistant Professor.Search for more papers by this authorChien-Nan Lee
Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
Associate Professor.Search for more papers by this authorCarol A. Landis
Department of Biobehavioral Nursing & Health Systems, University of Washington, Seattle, WA
Professor.Search for more papers by this authorShao-Yu Tsai,
Jou-Wei Lin,
Lu-Ting Kuo,
Chien-Nan Lee,
Carol A. Landis,
Corresponding Author
Shao-Yu Tsai
Department of Nursing, National Taiwan University, No. 1, Sec 1, Jen-Ai Rd, Taipei, 10051 Taiwan
Assistant Professor.Correspondence to Shao-Yu TsaiSearch for more papers by this authorJou-Wei Lin
Department of Medicine, National Taiwan University, Taipei, Taiwan
Associate Professor.Search for more papers by this authorLu-Ting Kuo
Department of Surgery, National Taiwan University, Taipei, Taiwan
Assistant Professor.Search for more papers by this authorChien-Nan Lee
Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
Associate Professor.Search for more papers by this authorCarol A. Landis
Department of Biobehavioral Nursing & Health Systems, University of Washington, Seattle, WA
Professor.Search for more papers by this authorThis work was supported by National Science Council, Taiwan, NSC 99-2314-B-002-002 and NSC 100-2314-B-002-029-MY3. The authors would like to thank Wen-Li Lin, Wen-Hsin Chang, and Zin-Hye Yang for their assistance in data collection. Special thanks to the women who participated in the study.
Abstract
We prospectively examined the associations of nighttime and daytime sleep during the third trimester of pregnancy with labor duration and risk of cesarean deliveries in a convenience sample of 120 nulliparous women who completed sleep-related questionnaires and wore wrist actigraphs for up to 7 days. Nap duration and 24-hour sleep duration were inversely associated with labor duration in women with vaginal delivery. Neither actigraphy-derived nor self-reported sleep variables were associated with type of delivery (e.g., vaginal, cesarean). Results showed a beneficial effect of sleep on labor duration and suggest that studies of sleep duration effects on labor and pregnancy outcomes require a consideration of the amount of both daytime and nighttime sleep. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36: 612–622, 2013
References
- Abeysena, C., Jayawardana, P., & Seneviratne, R. (2009). Maternal sleep deprivation is a risk factor for small for gestational age: A cohort study. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 49, 382–387. doi: 10.1111/j.1479-828X.2009.01010.x
- Asada, T., Motonaga, T., Yamagata, Z., Uno, M., & Takahashi, K. (2000). Associations between retrospectively recalled napping behavior and later development of Alzheimer's disease: Association with APOE genotypes. Sleep, 23, 629–634.
- Baratte-Beebe, K. R., & Lee, K. (1999). Sources of midsleep awakenings in childbearing women. Clinical Nursing Research, 8, 386–397. doi: 10.1177/10547739922158377
- Buysse, D. J., Reynolds, C. F., III, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.
- Buysse, D. J., Reynolds, C. F., III, Monk, T. H., Hoch, C. C., Yeager, A. L., & Kupfer, D. J. (1991). Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep, 14, 331–338.
- Campos, H., & Siles, X. (2000). Siesta and the risk of coronary heart disease: Results from a population-based, case-control study in Costa Rica. International Journal of Epidemiology, 29, 429–437. doi: 10.1093/ije/29.3.429
- Chen, Y. R., Yang, T. H., Yang, M. C., Yang, M. L., Hong, C. H., & Yuan, C. C. (2006). Cesarean section. Clinical Medicine, 58, 57–61.
- Chien, C. P., & Cheng, T. A. (1985). Depression in Taiwan: Epidemiological survey utilizing the CES-D. Seishin Shinkeigaku Zasshi, 87, 335–338.
- de Souza, L., Benedito-Silva, A. A., Pires, M. L., Poyares, D., Tufik, S., & Calil, H. M. (2003). Further validation of actigraphy for sleep studies. Sleep, 26, 81–85.
- Evans, M. L., Dick, M. J., & Clark, A. S. (1995). Sleep during the week before labor: Relationships to labor outcomes. Clinical Nursing Research, 4, 238–249; discussion 250–252. doi: 10.1177/105477389500400302
- Facco, F. L., Grobman, W. A., Kramer, J., Ho, K. H., & Zee, P. C. (2010). Self-reported short sleep duration and frequent snoring in pregnancy: Impact on glucose metabolism. American Journal of Obstetrics and Gynecology, 203, e141–e145. doi: 10.1016/j.ajog.2010.03.041
- Gay, C. L., Lee, K. A., & Lee, S. Y. (2004). Sleep patterns and fatigue in new mothers and fathers. Biological Research for Nursing, 5, 311–318. doi: 10.1177/1099800403262142
- Goyal, D., Gay, C., & Lee, K. (2009). Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Archives of Women's Mental Health, 12, 229–237. doi: 10.1007/s00737-009-0070-9
- Hays, J. C., Blazer, D. G., & Foley, D. J. (1996). Risk of napping: Excessive daytime sleepiness and mortality in an older community population. Journal of the American Geriatrics Society, 44, 693–698.
- Izci-Balserak, B., & Pien, G. W. (2010). Sleep-disordered breathing and pregnancy: Potential mechanisms and evidence for maternal and fetal morbidity. Current Opinion in Pulmonary Medicine, 16, 574–582. doi: 10.1097/MCP.0b013e32833f0d55
- Johnston, S. K., Landis, C. A., Lentz, M. J., & Shaver, J. L. (2001). Self-reported nap behavior and polysomnography at home in midlife women with and without insomnia. Sleep, 24, 913–919.
- Kennelly, M. M., Fallon, A., Farah, N., Stuart, B., & Turner, M. J. (2011). Effects of body mass index on sleep patterns during pregnancy. Journal of Obstetrics & Gynaecology, 31, 125–127. doi: 10.3109/01443615.2010.536861
- Kushida, C. A., Chang, A., Gadkary, C., Guilleminault, C., Carrillo, O., & Dement, W. C. (2001). Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Medicine, 2, 389–396.
- Lee, K. A., Baker, F. C., Newton, K. M., & Ancoli-Israel, S. (2008). The influence of reproductive status and age on women's sleep. Journal of Women's Health (Larchmont), 17, 1209–1214. doi: 10.1089/jwh.2007.0562
- Lee, K. A., & Gay, C. L. (2004). Sleep in late pregnancy predicts length of labor and type of delivery. American Journal of Obstetrics and Gynecology, 191, 2041–2046. doi: 10.1016/j.ajog.2004.05.086
- Lee, K. A., McEnany, G., & Zaffke, M. E. (2000). REM sleep and mood state in childbearing women: Sleepy or weepy? Sleep, 23, 877–885.
- Micheli, K., Komninos, I., Bagkeris, E., Roumeliotaki, T., Koutis, A., & Kogevinas, M. (2011). Sleep patterns in late pregnancy and risk of preterm birth and fetal growth restriction. Epidemiology, 22, 738–744. doi: 10.1097/EDE.0b013e31822546fd
- Mindell, J. A., & Jacobson, B. J. (2000). Sleep disturbances during pregnancy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 29, 590–597. doi: 10.1111/j.1552-6909.2000.tb02072.x
- Morgenthaler, T., Alessi, C., Friedman, L., Owens, J., Kapur, V., & Boehlecke, B. (2007). Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: An update for 2007. Sleep, 30, 519–529.
- Naghi, I., Keypour, F., Ahari, S. B., Tavalai, S. A., & Khak, M. (2011). Sleep disturbance in late pregnancy and type and duration of labour. Journal of Obstetrics and Gynaecology, 31, 489–491. doi: 10.3109/01443615.2011.579196
- Naska, A., Oikonomou, E., Trichopoulou, A., Psaltopoulou, T., & Trichopoulos, D. (2007). Siesta in healthy adults and coronary mortality in the general population. Archives of Internal Medicine, 167, 296–301. doi: 10.1001/archinte.167.3.296
- National Sleep Foundation. (2007). Women and sleep: Sleep in America polls. Retrieved April 26, 2012, from http://www.sleepfoundation.org/article/sleep-america-polls/2007-women-and-sleep
- Neau, J. P., Texier, B., & Ingrand, P. (2009). Sleep and vigilance disorders in pregnancy. European Neurology, 62, 23–29. doi: 10.1159/000215877
- Oakley, N. R. (1997). Validation with polysomnography of the Sleepwatch sleep/wake scoring algorithm used by the actiwatch activity monitoring system. Bend, OR: Mini Mitter Co., Inc.
- Okun, M. L., & Coussons-Read, M. E. (2007). Sleep disruption during pregnancy: How does it influence serum cytokines? Journal of Reproductive Immunology, 73, 158–165. doi: 10.1016/j.jri.2006.06.006
- Okun, M. L., Hanusa, B. H., Hall, M., & Wisner, K. L. (2009). Sleep complaints in late pregnancy and the recurrence of postpartum depression. Behavioral Sleep Medicine, 7, 106–117. doi: 10.1080/15402000902762394
- Okun, M. L., Luther, J. F., Wisniewski, S. R., Sit, D., Prairie, B. A., & Wisner, K. L. (2012). Disturbed sleep, a novel risk factor for preterm birth? Journal of Women's Health (Larchmt), 21, 54–60. doi: 10.1089/jwh.2010.2670
- Okun, M. L., Roberts, J. M., Marsland, A. L., & Hall, M. (2009). How disturbed sleep may be a risk factor for adverse pregnancy outcomes. Obstetrical & Gynecological Survey, 64, 273–280. doi: 10.1097/OGX.0b013e318195160e
- Okun, M. L., Schetter, C. D., & Glynn, L. M. (2011). Poor sleep quality is associated with preterm birth. Sleep, 34, 1493–1498. doi: 10.5665/sleep.1384
- Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996). A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Epidemiology, 49, 1373–1379.
- Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
- Reutrakul, S., Zaidi, N., Wroblewski, K., Kay, H. H., Ismail, M., & Ehrmann, D. A. (2011). Sleep disturbances and their relationship to glucose tolerance in pregnancy. Diabetes Care, 34, 2454–2457. doi: 10.2337/dc11-0780
- Signal, T. L., Gander, P. H., Sangalli, M. R., Travier, N., Firestone, R. T., & Tuohy, J. F. (2007). Sleep duration and quality in healthy nulliparous and multiparous women across pregnancy and post-partum. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 47, 16–22. doi: 10.1111/j.1479-828X.2006.00672.x
- Skouteris, H., Wertheim, E. H., Germano, C., Paxton, S. J., & Milgrom, J. (2009). Assessing sleep during pregnancy: A study across two time points examining the Pittsburgh Sleep Quality Index and associations with depressive symptoms. Women's Health Issues, 19, 45–51. doi: 10.1016/j.whi.2008.10.004
- Soldatos, C. R., Allaert, F. A., Ohta, T., & Dikeos, D. G. (2005). How do individuals sleep around the world? Results from a single-day survey in ten countries. Sleep Medicine, 6, 5–13.
- Steptoe, A., Peacey, V., & Wardle, J. (2006). Sleep duration and health in young adults. Archives of Internal Medicine, 166, 1689–1692. doi: 10.1001/archinte.166.16.1689
- Stone, K. L., Ewing, S. K., Ancoli-Israel, S., Ensrud, K. E., Redline, S., & Bauer, D. C. (2009). Self-reported sleep and nap habits and risk of mortality in a large cohort of older women. Journal of the American Geriatrics Society, 57, 604–611. doi: 10.1111/j.1532-5415.2008.02171.x
- Strange, L. B., Parker, K. P., Moore, M. L., Strickland, O. L., & Bliwise, D. L. (2009). Disturbed sleep and preterm birth: A potential relationship? Clinical and Experimental Obstetrics & Gynecology, 36, 166–168.
- Tang, S. T., Li, C. Y., & Liao, Y. C. (2007). Factors associated with depressive distress among Taiwanese family caregivers of cancer patients at the end of life. Palliative Medicine, 21, 249–257. doi: 10.1177/0269216307077334
- Tsai, P. S., Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., & Huang, C. J. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research, 14, 1943–1952. doi: 10.1007/s11136-005-4346-x
- Tsai, S. Y., Kuo, L. T., Lai, Y. H., & Lee, C. N. (2011). Factors associated with sleep quality in pregnant women: A prospective observational study. Nursing Research, 60, 405–412. doi: 10.1097/NNR.0b013e3182346249
- Williams, M. A., Miller, R. S., Qiu, C., Cripe, S. M., Gelaye, B., & Enquobahrie, D. (2010). Associations of early pregnancy sleep duration with trimester-specific blood pressures and hypertensive disorders in pregnancy. Sleep, 33, 1363–1371.
- Xu, Q., Song, Y., Hollenbeck, A., Blair, A., Schatzkin, A., & Chen, H. (2010). Day napping and short night sleeping are associated with higher risk of diabetes in older adults. Diabetes Care, 33, 78–83. doi: 10.2337/dc09-1143
- Zafarghandi, N., Hadavand, S., Davati, A., Mohseni, S. M., Kimiaiimoghadam, F., & Torkestani, F. (2012). The effects of sleep quality and duration in late pregnancy on labor and fetal outcome. The Journal of Maternal-Fetal & Neonatal Medicine, 25, 535–537. doi: 10.3109/14767058.2011.600370
Citing Literature
