Abstract
Background
Pregnancy is a critical period during which women usually do not prefer taking medication. Therefore, non-pharmacological and safe methods are needed to improve sleep quality during pregnancy. This study aims to identify whether an educational program on sleep enhancement for pregnant women has any effect on maternal sleep quality.
Method
This was a randomized-controlled trial. Pregnant women (N = 181) were divided into two groups, an intervention group (n = 90) and a control group (n = 91). A two-session educational program for the enhancement of sleep quality was provided to the intervention group, whereas solely the routine practices of the hospital were put in place for the control group.
Results
The intervention group had a significantly lower mean Pittsburgh Sleep Quality Index score, and accordingly, better sleep quality than the control group. Participation in the education program was significantly related to sleep quality and accounted for 6% of the total variance in sleep quality (R2 = 0.055) (p < 0.001).
Conclusion
It was concluded that the educational program on sleep enhancement implemented to improve the sleep quality of pregnant women enhanced maternal sleep quality.
Trial Registration
URL: clinicaltrials.gov. Registration number: NCT04262349.
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Data Availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Sut HK, Asci O, Topac N. Sleep quality and health-related quality of life in pregnancy. J Perinat Neonatal Nurs. 2016;30(4):302–9. https://doi.org/10.1097/JPN.0000000000000181.
Paulino DSM, Borrelli CB, Faria-Schützer DB, Brito LGO, Surita FG. Non-pharmacological interventions for improving sleep quality during pregnancy: a systematic review and meta-analysis. Rev Bras Ginecol Obstet. 2022;44(8):776–84. https://doi.org/10.1055/s-0042-1746200.
Cai S, Tan S, Gluckman PD, et al. Sleep quality and nocturnal sleep duration in pregnancy and risk of gestational diabetes mellitus. Sleep. 2017;40:1477–83. https://doi.org/10.1093/sleep/zsw058.
Christian LM, Carroll JE, Porter K, Hall MH. Sleep quality across pregnancy and postpartum: effects of parity and race. Sleep Health. 2019;5(4):327–34. https://doi.org/10.1016/j.sleh.2019.03.005.
Galaye B, Addae G, Neway B, et al. Poor sleep quality, antepartum depression and suicidal ideation among pregnant women. J Affect Disord. 2017;209:195–200. https://doi.org/10.1016/j.jad.2016.11.020.
Mindell JA, Cook RA, Nikolovski J. Sleep patterns and sleep disturbances across pregnancy. Sleep Med. 2015;16(4):483–8. https://doi.org/10.1016/j.sleep.2014.12.0068.
Tsai SY, Lee PL, Lin JW, Lee CN. Cross-sectional and longitudinal associations between sleep and health-related quality of life in pregnant women: a prospective observational study. Int J Nurs Stud. 2016;56:45–53. https://doi.org/10.1016/j.ijnurstu.2016.01.001.
Kizilirmak A, Timur S, Kartal B. Insomnia in pregnancy and factors related to insomnia. Sci World J. 2012;2012:1–8. https://doi.org/10.1100/2012/197093.
Rashed ABAA, Khalil AK, Shereda Mohamed HA. Effect of non-pharmacological interventions on sleep quality during pregnancy among primigravida. South Asian Res J Nurs Health Care. 2019;1(1):8–17. https://doi.org/10.36346/sarjnhc.2019.v01i01.002.
Stremler R, Hodnett E, Kenton L, Lee K, Weiss S, Weston J, Willan A. Effect of behavioural-educational intervention on sleep for primiparous women and their infants in early postpartum: multisite randomised controlled trial. BMJ. 2013 Mar 20;346:1-14.. https://doi.org/10.1136/bmj.f1164.
Santos MAD, Conceição APD, Ferretti-Rebustini REL, Ciol MA, Heithkemper MM, Cruz DALMD. Non-pharmacological interventions for sleep and quality of life: a randomized pilot study. Rev Lat Am Enfermagem. 2018;14:26. https://doi.org/10.1590/1518-8345.2598.3079.
Bakır V. Mindfulness-based cognitive therapy: basic philosophy, concepts, therapeutic process, criticisms and contributions. Bilge Int J Social Res. 2021;5(1):21–7. https://doi.org/10.47257/busad.934436.
Polo-Kantola P, Aukia L, Karlsson H, Karlsson L, Paavonen EJ. Sleep quality during pregnancy: associations with depressive and anxiety symptoms. Acta Obstet Gynecol Scand. 2017;96(2):198–206. https://doi.org/10.1111/aogs.13056.
Rezaei E, Moghadam ZB, Nejat S, Dehghannayeri N. The impact of behavioral health sleep education on the depression of pregnant women with disorders sleep: a randomaized control trial, year 2012. Iran J Nurs Midwifery Res . 2014 Sep;19(5):508-16. https://pubmed.ncbi.nlm.nih.gov/25400680/
Sonmez A, Aksoy DY. Effects of sleep hygiene training given to pregnant women with restless leg syndrome on their sleep quality. Sleep Breath. 2018;22(2):527–35. https://doi.org/10.1007/s11325-018-1619-5.
Zhang H, Li P, Fan D, et al. Prevalence of and risk factors for poor sleep during different trimesters of pregnancy among women in China: a cross-sectional study. Nat Sci Sleep. 2021;13:811–20. https://doi.org/10.2147/NSS.S303763.
Leppink J, O’Sullivan P, Winston K. Effect size – large, medium, and small. Perspect Med Educ. 2016;5(6):347–9.
Random.org/ sequences. (n.d.). Available from https://www.random.org/integers/. Available date: 01 February 2020.
Koybasi ES, Oskay UY. Effects of pregnancy process on the quality of sleep. Gulhane Medical J. 2017;59(1):1–5. https://doi.org/10.5455/gulhane.222441.
Agargun MY, Kara H, Anlar O. The validity and reliability of the Pittsburgh Sleep Quality Index. Turkish J Psychiatry. 1996;7(2):107–115.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.
Ozkan SA, Rathfisch G. The effect of relaxation exercises on sleep quality in pregnant women in the third trimester: a randomized controlled trial. Complement Ther Clin Pract. 2018;32(May):79–84. https://doi.org/10.1016/j.ctcp.2018.05.008.
Harvey AG, Stinson K, Whitaker KL, Moskovitz D, Virk H. The subjective meaning of sleep quality: a comparison of individuals with and without insomnia. Sleep. 2008;31(3):383–93. https://doi.org/10.1093/sleep/31.3.383.
Li G, Kong L, Zhou H, Kang X, Fang Y, Li P. Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience. Sleep Med. 2016;25:8–12. https://doi.org/10.1016/j.sleep.2016.02.015.
Acknowledgements
The authors thank all pregnant women who volunteered to participate in the study and sincerely shared their views.
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Contributions
HBO: conceptualization, methodology, software, validation, formal analysis, investigation, resources, data curation, writing — original draft, writing — review and editing, visualization, supervision, project administration; NS: conceptualization, methodology, validation, investigation, writing — original draft, writing — review and editing, visualization, supervision, project administration.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study. The pregnant women who volunteered to participate in the research were required by the researcher to fill in the informed consent form. The permission to conduct the research was received from the Non-Invasive Clinical Trials Ethics Committee (endorsement no. 2018/160, clinical trial no.: NCT04262349). In addition, institutional permission was obtained from the Provincial Health Directorate.
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This article contains a study with human participants. This article does not contain any studies with animals performed by any of the authors.
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Bay Ozcalik, H., Sogukpinar, N. The Effect of Sleep Enhancement Educational Program on Maternal Sleep Quality for Nulliparous Pregnant Women: A Randomized-Controlled Trial. Int.J. Behav. Med. (2024). https://doi.org/10.1007/s12529-024-10261-x
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DOI: https://doi.org/10.1007/s12529-024-10261-x