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Factors associated with poor sleep quality and excessive daytime sleepiness in late pregnancy: A pilot study in an antenatal unit

Objectives: To assess factors associated with poor sleep quality and excessive daytime sleepiness (EDS) in late pregnancy. Methods: A cross sectional study was carried out on 109 pregnant women in their third trimester admitted to Teaching Hospital Peradeniya using validated Sinhala translations of both Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Consecutive sampling was used from February to April 2021. Results: Application of PSQI demonstrated that 59.6% had a poor overall sleep quality (PSQI score>5). Subcomponent analysis showed poor sleep duration (< 06 hours per day) in 27.5%, sleep latency of over 30 minutes in 29.4%, poor sleep efficiency among 33.9% and day-time dysfunction in 30.3%. Poor overall sleep quality was associated with presence of foetal movements (OR=11.8, 95% CI=1.5-93.5) and backache (OR=3.8, 95% CI=1.2-12.3). Poor sleep duration was associated with the presence of one or more pregnancy related complications (OR=3.4, 95% CI=1.4-8.5) and advanced maternal age over 35 years (OR=3.7, 95% CI=1.4-9.7). Increased sleep latency over 30 minutes was seen in mothers over 34 weeks of gestation (OR=9.1, 95% CI=2.9-28.6) and over 10kg of weight gain (OR=5.3, 95% CI=1.2-24.4). Application of ESS demonstrated 26.6% had EDS, which was associated with maternal employment (OR=2.8, 95% CI=1.1-7.1) and higher educational status (OR=4.7, 95% CI=1.5-15.1). EDS did not result in poor sleep quality, however, mothers experiencing insomnia had a higher PSQI score (Mean ± SD 7.2±3.7 vs 6.2±3.4 hours, p=0.044). Conclusion: Majority of pregnant women in third trimester had poor overall sleep quality. EDS was seen among one fourth. Modifiable risk factors were associated with poor sleep quality and EDS.