Clinical ReviewSleep deprivation during pregnancy and maternal and fetal outcomes: Is there a relationship?
Introduction
Sleep deprivation has become a major public health concern in the United States because of its detrimental effects on cognitive functioning over time, accidents and errors in the workplace, and alterations in metabolic and endocrine function of individuals.1 Increasing evidence also suggests that sleep deprivation may increase mortality.1, 2 To date, despite the multiple competing demands women face in modern society,3 75% of sleep research has been conducted in men,4 although there is increased interest in sleep research in women. To meet the demands and opportunities of our modern society, having adequate sleep is often at the bottom of the priority list for American women who try to balance work and family life.3
During pregnancy and the postpartum period, women are at particular risk for sleep restriction because of the physical changes of pregnancy and the need to provide frequent infant care. Pregnancy and the postpartum period are also times when women are at a heightened risk of depression.5 Maternal depression has been well documented to adversely impact maternal–child relationships, parenting practices, family functioning, and children's development and general well-being.5 Several authors have hypothesized that sleep deprivation may increase the risk of adverse maternal and fetal outcomes. Limited evidence also suggests an association between sleep problems and maternal depression. This article reviews what is currently known about the relationship between sleep duration during pregnancy and maternal and fetal outcomes, with a special emphasis on preterm delivery and postpartum depression.
Section snippets
The prevalence of sleep deprivation
Although sleep needs may vary by age and gender, the National Sleep Foundation has recommended 7–8 h of sleep per 24 h for adults.6 Research has shown that sleep duration in healthy young adults stabilized at approximately 8.2 h after elimination of prior sleep debt.7 However, studies have indicated that the self-reported sleep duration of Americans has decreased by 1.5–2 h over the past 40 years, to a mean of 7–7.9 h.8, 9, 10 Average nightly sleep duration has declined even more over the past
Effect of sleep deprivation
In 2004, the U.S. Surgeon General observed that sleep disorders, sleep deprivation, and sleepiness affect as many as 70 million Americans and result in $16 billion in annual health-care expenses and $50 billion in lost productivity.17 The effects of sleep deprivation are cumulative, such that a mild reduction in sleep duration each night could, over time, result in significant functional deficits.18 Chronic sleep deprivation has detrimental effects on fat and glucose metabolism, inflammatory
Sleep duration during pregnancy
Sleep in women is affected by physiologic changes in neuroendocrine hormones, body temperature, mood, and emotional state during puberty, the menstrual cycle, pregnancy and menopause.24 In the past decade, sleep patterns and problems in women in the childbearing years have received increased research interest. However, few studies have focused on pregnancy. Using subjective sleep data, Hedman and coworkers surveyed 325 pregnant Finnish women and found that the mean hours of total self-reported
Effect of sleep deprivation on maternal and fetal health
Despite the potential adverse effect of sleep deprivation on maternal and fetal outcomes, little research has investigated the prevalence of and risk factors for sleep deprivation during pregnancy and the postpartum period, or the relationship between sleep and pregnancy outcomes. Limited research has indicated that poor sleep may be detrimental to the labor and delivery process. In a prospective observational study of 131 healthy primiparous women in their ninth month of pregnancy, Lee and Gay
Conclusion
Lack of sleep affects our physical and mental health. Although the average sleep duration in the American population has declined for both sexes, research has shown that more women than men report not getting the sleep they need.11 Pregnant women particularly need sufficient sleep to nourish the development of their infants and the energy they need for the labor and delivery process. Sleep deprivation during pregnancy has been associated with longer labor, elevated perception of pain and
Acknowledgements
This study was supported by KL2 Multidisciplinary Clinical Research Career Development Program Scholar (KL2RR024994) award from NIH.
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2023, Journal of Affective DisordersDepressive symptoms and sleep disturbances in late pregnancy: Associations with experience of induction of labor with a catheter
2023, European Journal of Obstetrics and Gynecology and Reproductive Biology
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