护理SCI晨读:客观睡眠效率而非主观睡眠质量与孕妇的抑郁风险相关:一项前瞻性观察队列研究

2021
05/18

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NursingResearch护理研究前
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健康的孕妇在孕早期会经历客观和主观的睡眠障碍,其中很大一部分人在整个怀孕期间也会出现高度的抑郁症状。


护理SCI晨读:

客观睡眠效率而非主观睡眠质量与孕妇的抑郁风险相关:一项前瞻性观察队列研究

 



 



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摘要

背景

睡眠障碍是例行产前检查中最常见的主诉之一。睡眠和情绪障碍通常是相互交织的,尤其是抑郁症是导致世界范围内残疾和疾病负担的主要原因,与男性相比,女性更容易受到影响。然而,少有研究前瞻性地研究孕妇睡眠障碍与抑郁的纵向风险之间的关系,尚无研究客观估计白天和晚上的睡眠时间以及睡眠中断的程度。

目的

验证孕妇的客观和主观睡眠障碍与抑郁症状的预测性和纵向相关性。

设计

前瞻性观察队列研究。

方法

从大学附属医院招募的204名孕早期孕妇,收集社会人口统计学和健康信息,戴手腕检测仪7天,并完成了匹兹堡睡眠质量指数,流行病学研究中心的抑郁量表和Epworth嗜睡量表。并执行相同的数据收集程序两次,每个数据收集计划至少间隔8周。通过估计未调整和多变量调整后的比值比和95个%置信区间,评估第一个周期的各种类型的睡眠障碍以及随访抑郁症的风险。

结果

121名(59.3%)的初孕妇女的睡眠效率低于85%,而匹兹堡睡眠质量指数的全球评分高于5分的女性为92(45.1%),表明睡眠质量较差。在多变量调整的模型,第一个周期客观测量的睡眠效率<85%与三个周期抑郁症的风险2.71-,3.87-,5.27倍增加相关。

结论

健康的孕妇在孕早期会经历客观和主观的睡眠障碍,其中很大一部分人在整个怀孕期间也会出现高度的抑郁症状。客观评估的睡眠质量差,而不是自我报告的睡眠不安,可能在孕期偏高,持续的抑郁症状发展中的发挥主要作用。未来有必要使用客观的睡眠测量和临床诊断性访谈进行研究,以检查旨在改善睡眠的早期干预措施是否有助于降低妊娠妇女的抑郁症状高发风险和降低抑郁症发生率。

Abstract

Background

Sleep disturbances are one of the most frequent chief complaints brought to the healthcare professionals during routine prenatal care visits. Sleep and mood disturbances are often intertwined, and depression in particular is a leading cause of disability and disease burden worldwide with women more likely to be affected than men. However, limited studies have prospectively investigated the association between sleep disturbances and longitudinal risk of depression in pregnant women, with no studies using actigraphy to objectively estimate daytime and nighttime sleep duration and the extent of sleep disruption.

Objectives

To examine the predictive and longitudinal association of objective actigraphic and subjective sleep disturbances with depressive symptoms in pregnant women.

Design

A prospective observational cohort study.

Methods

204 first-trimester pregnant women recruited from a university-affiliated hospital provided socio-demographic and health information, wore a wrist actigraph for 7 days, and completed Pittsburgh Sleep Quality Index, Center for Epidemiologic Studies - Depression Scale, and Epworth Sleepiness Scale. Identical data collection procedures were implemented again in the second and third trimester, with each data collection scheduled at least 8 weeks apart. We estimated unadjusted and multivariable adjusted odds ratios and 95% confidence intervals to evaluate various types of sleep disturbances at 1st trimester and risk of depression at follow-ups.

Results

121 (59.3%) first-trimester women had a sleep efficiency of < 85% by actigraphy, and 92 (45.1%) had Pittsburgh Sleep Quality Index global scores > 5 indicative of poor sleep quality. In multivariable adjusted models, 1st trimester objectively measured sleep efficiency < 85% was associated with 2.71-, 3.87-, and 5.27-fold increased odds having risk of depression at 2nd trimester, 3rd trimester, and both 2nd and 3rd trimesters, respectively.

Conclusions

Healthy pregnant women experience both objective and subjective sleep disturbances during the early trimester, with a substantial proportion of them also having high depressive symptoms throughout the pregnancy. Objectively assessed poor sleep quality in the 1st trimester, but not self-reported characteristics of disturbed sleep, may play a role in the development of both elevated and persistent high depressive symptoms in pregnancy. Future studies using objective sleep measurements and clinical diagnostic interviews are warranted to examine whether an early intervention aiming at improving sleep may help reduce high depressive symptom risk and lower depression rate in women during pregnancy.

Tweetable abstract: Objectively assessed poor sleep efficiency in the 1st trimester predicts both elevated and persistent high depressive symptoms in pregnancy.



原文链接:

https://www.sciencedirect.com/science/article/pii/S0020748921001115


THE

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本文由作者自行上传,并且作者对本文图文涉及知识产权负全部责任。如有侵权请及时联系(邮箱:nanxingjun@hmkx.cn
关键词:
睡眠障碍,前瞻性,抑郁症,效率,孕妇,风险,护理

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