Purpose

Pregnancy-related psychophysiological changes are associated with the sleep alterations as the gestational weeks progress. The aim is to evaluate the effectiveness of sleep hygiene education programs during pregnancy.

Methods

This prospective randomized controlled study based on pre–post-test after intervention consists of 30 studies and 30 control groups. Pregnant descriptive form, Beck Depression Index (BDI), Pittsburgh Sleep Quality Index (PSQI) and sleep hygiene index (SHI) questionnaires were used. Pregnant women with a score of 15 and above according to BDI were excluded from the study due to depression. Following the application of PSQI and SHI as a pretest, a sleep hygiene training program was applied to the intervention group twice with an interval of 15 days, and PSQI and SHI surveys were repeated as a posttest at the end of 1 month. End points with prespecified hypotheses were changes in sleep quality in different trimesters during antenatal follow-up (primary end point) and changes in sleep quality after the sleep hygiene education intervention from randomization to the end of the intervention period (secondary end point).

Results

90% of all pregnant women had poor sleep quality in the pre-test, and 93.3% in the post-test. In the intervention group, the pre-test PSQI score was 8.10 ± 1.80 and the post-test PSQI score was 8.37 ± 2.05 (p < 0.001). In the control group, the pre-test PSQI score was 8.23 ± 2.54 and the post-test PSQI score was 9.77 ± 2.54, and the worsening of sleep quality became more evident (p < 0.05). While the SHI in intervention group was 16.57 ± 5.64 in the pre-test, it was 10.30 ± 3.78 in the post-test after sleep hygiene training (p < 0.001). In the control group, the pre-test SHI scores increased from 14.50 ± 3.78 to the post-test scores of 16.60 ± 4.36, resulting in a decline in sleep hygiene and sleep quality (p < 0.05).

Conclusion

As the gestational week progressed, the deterioration in sleep quality increased. The poor sleep quality improved significantly after sleep hygiene education counseling. It is recommended to add sleep-related screenings to routine pregnancy follow-ups and to provide sleep hygiene education.

中文翻译：

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孕期睡眠卫生教育计划：一项前瞻性随机对照研究

目的

随着孕周的进展，与怀孕相关的心理生理变化与睡眠变化有关。目的是评估怀孕期间睡眠卫生教育计划的有效性。

方法

这项基于干预后前后测试的前瞻性随机对照研究由 30 项研究和 30 个对照组组成。使用怀孕描述形式、贝克抑郁指数（BDI）、匹兹堡睡眠质量指数（PSQI）和睡眠卫生指数（SHI）问卷。 BDI 得分为 15 分及以上的孕妇因抑郁症而被排除在研究之外。以PSQI和SHI作为预测后，干预组进行两次睡眠卫生训练，间隔15天，并在1个月末重复PSQI和SHI调查作为后测。预设假设的终点为产前随访期间不同孕期睡眠质量的变化（主要终点）和睡眠卫生教育干预后从随机到干预期结束时睡眠质量的变化（次要终点）。

结果

90%的孕妇在前测中睡眠质量较差，在后测中这一比例为93.3%。在干预组中，测试前PSQI得分为8.10±1.80，测试后PSQI得分为8.37±2.05（p  <0.001）。对照组测前PSQI评分为8.23±2.54，测后PSQI评分为9.77±2.54，睡眠质量恶化更加明显（p  <0.05）。干预组前测 SHI 为 16.57 ± 5.64，睡眠卫生训练后后测 SHI 为 10.30 ± 3.78（p  < 0.001）。对照组中，测试前的 SHI 评分从 14.50 ± 3.78 上升至测试后的 16.60 ± 4.36，导致睡眠卫生和睡眠质量下降（p  < 0.05）。

结论

随着孕周的增加，睡眠质量恶化。睡眠质量差的人经过睡眠卫生教育辅导后明显改善。建议在常规妊娠随访中增加与睡眠相关的筛查，并提供睡眠卫生教育。