8, 9 Even absent of a formal OSA diagnosis, 30–40% of the pregnant women endorse snoring, a prognostic marker for OSA. 5 SDB shows similar patterns based on polysomnography (PSG) and home sleep testing (HST) and estimated prevalence of obstructive sleep apnea (OSA) in the US is between 3.6% and 10.5% in the 1st and 2nd trimesters, which increases to 26.7% in the 3rd trimester. Estimates indicate that insomnia may affect >50% of the pregnant women and that severity is highest in the 3rd trimester. 1– 7 Insomnia and sleep-disordered breathing (SDB) are among the two most common sleep issues in the prenatal period. Poor quality and insufficient sleep are endemic to pregnant women. Keywords: sleep aids, sleep apnea, Medicaid, perinatal, prenatal
Poverty-related sleep issues are linked to insomnia, obesity-related disparities center on sleep-related breathing and medication use, and racial disparities relate to short sleep. Problematic sleep disproportionately affects women in poverty, who self-identify as black, and who are obese before pregnancy. Black women reported shorter sleep duration than white women but differed on no other sleep parameters.Ĭonclusion: Clinical signs of insomnia and sleep-disordered breathing are common in mid-to-late pregnancy, but most cases go undetected. Obesity before pregnancy was related to poor sleep quality, snoring, sleep aids, and short sleep. Poverty was uniquely related to increased insomnia symptoms and trouble sleeping due to bad dreams. However, adjusted models revealed specificity. In unadjusted models, poverty, Medicaid coverage, self-identifying as black, and obesity before and during pregnancy (BMI ≥ 35) were associated with a wide range of sleep problems. Yet, only 3.4% of the women reported an insomnia diagnosis and 3.0% reported a sleep apnea diagnosis. Results: As high as 76.2% of the women reported global sleep disturbance, 30.6% endorsed snoring, 24.3% sleep <6 hrs/night, and over half screened positive for clinical insomnia.
Body mass index (BMI) and patient insurance were derived from medical records. Participants: A total of 267 pregnant women (27.3% non-Hispanic black gestational age: 27.99☑.20 weeks) completed online surveys on sleep quality, insomnia symptoms, sleep aid use, signs/symptoms of sleep-disordered breathing, and sociodemographics. Setting: Large multi-site health system in Metro Detroit. Objective: To characterize sleep habits and parameters among women in mid-to-late pregnancy and to identify disparities associated with poverty, race, and obesity. Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Novi, MI, USA David A Kalmbach, 1 Philip Cheng, 1 Roopina Sangha, 2 Louise M O’Brien, 3 Leslie M Swanson, 4 Laura Palagini, 5 Luisa F Bazan, 6 Thomas Roth, 1 Christopher L Drake 1ġThomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Novi, MI, USA 2Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA 3Departments of Obstetrics &Gynecology and Neurology, University of Michigan, Ann Arbor, MI, USA 4Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA 5Departments of Neuroscience and Psychiatry, University of Pisa, Pisa, Italy 6Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, USA
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