Evaluation of Sleep in Pregnant Inpatients Compared With Outpatients.

Obstet Gynecol

Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, the Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, the Division of Obstetric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, and the Department of Pediatrics, Stanford University, and Stanford University School of Medicine, Palo Alto, and the Department of Biomedical Data Science, Stanford University, Stanford, California.

Published: June 2024

Objective: To evaluate whether antepartum hospitalization was associated with differences in sleep duration or disrupted sleep patterns.

Methods: This was a prospective cohort study with enrollment of pregnant people aged 18-55 years with singleton gestations at 16 weeks of gestation or more between 2021 and 2022. Each enrolled antepartum patient was matched by gestational age to outpatients recruited from obstetric clinics at the same institution. Participants responded to the ISI (Insomnia Severity Index) and wore actigraph accelerometer watches for up to 7 days. The primary outcome was total sleep duration per 24 hours. Secondary outcomes included sleep efficiency (time asleep/time in bed), ISI score, clinical insomnia (ISI score higher than 15), short sleep duration (less than 300 minutes/24 hours), wakefulness after sleep onset, number of awakenings, and sleep fragmentation index. Outcomes were evaluated with multivariable generalized estimating equations adjusted for body mass index (BMI), sleep aid use, and insurance type, accounting for gestational age correlations. An interaction term assessed the joint effects of time and inpatient status.

Results: Overall 58 participants were included: 18 inpatients and 40 outpatients. Inpatients had significantly lower total sleep duration than outpatients (mean 4.4 hours [SD 1.6 hours] inpatient vs 5.2 hours [SD 1.5 hours] outpatient, adjusted β=-1.1, 95% CI, -1.8 to -0.3, P =.01). Awakenings (10.1 inpatient vs 13.8, P =.01) and wakefulness after sleep onset (28.3 inpatient vs 35.5 outpatient, P =.03) were lower among inpatients. There were no differences in the other sleep outcomes, and no interaction was detected for time in the study and inpatient status. Inpatients were more likely to use sleep aids (39.9% vs 12.5%, P =.03).

Conclusion: Hospitalized pregnant patients slept about 1 hour/day less than outpatients. Fewer awakenings and reduced wakefulness after sleep onset among inpatients may reflect increased use of sleep aids in hospitalized patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098687PMC
http://dx.doi.org/10.1097/AOG.0000000000005591DOI Listing

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