Quantification Of Subjective Sleep Quality In Healthy Nulliparous Pregnant, Post Partum And Post Menopausal Women In Shiraz, Using The Pittsburg Sleep Quality Index

Abstract

Quantification of subjective sleep quality in healthy nulliparous pregnant, post partum and post menopausal women in Shiraz, using the Pittsburg Sleep Quality Index Aim: To quantify and compare various sleep quality indices and corresponding variates amongst nulliparous pregnant, post partum and post menopausal women referring to outpatient obstetrics and gynecology facilities at Shiraz university affiliated hospitals ( July-December ,2010), in Shiraz, central southern Iran.Materials and Methods: In this cross sectional survey, 200 women of which 120 were pregnant[40 first trimester(PrT1), 40 second trimester(PrT2) and 40 third trimester(PrT3)],40 post partum(PP) and 40 post menopausal(PM) were asked to complete the self rated Pittsburg Sleep Quality Index(PSQI)questionnaire. Participants were matched on variables that could affect their sleep including age (PrT1, PrT2, PrT3 and PP), BMI, collar size, gestational age (for each trimester subjects separately) and, weeks post partum (PP). Exclusion criteria were known medical or psychiatric conditions. PP cases were specifically assessed for post partum depression(PPD) using the post partum depression screening scale(PDSS). Obtained data were compared across groups using independent sample t-test and one way ANOVA through SPSS 17.0 analyzer.Results: Global sleep quality score was most favorable in PrT2 subjects and showed to be poorest among PP cases (4.25±0.22 and 12.52±0.49, respectively). PM,PrT3 and PrT1 subjects in turn had poorer to more favorable total sleep quality. Concerning the PSQI components, worst sleep duration (PSQIDURAT),subjective sleep latency( PSQILATEN), sleep disturbance (PSQIDISTB) , self rated overall quality(PSQIQUAL),medication use(PSQIMEDS) and dysfunctional days (PSQIDAYDYS)belonged to PP(5.1±0.16) ,PM(48.35±6.42) ,PP(2.55±0.07) ,PrT2(1.00±0.05),PP(1.87±0.16),PP(2.2±0.16) groups, respectively. PP cases who suffered PPD had less effective sleep and reported more frequent wakes after sleep onset compared to those without PPD(p<.05).Conclusion: Post partum women with or without PPD suffer significantly a poorer sleep than other groups studied. Post menopausal and third trimester pregnant women were shown to have poorer sleep indices to lesser extent. Sleep quality in PrT1 and PrT2 does deteriorate however not to the level affecting patients activities of daily living.