Sleep disorders and effectiveness of various methods of insomnia therapy in pregnant women (Literature review)

О.V. Golyanovskiy, S. V. Frolov
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Abstract

Sleep disorders (dyssomnia) during pregnancy are of high prevalence and may be associated with negative peri- and postnatal outcomes. However, these conditions are often not effectively diagnosed and treated. In this review a systematic evaluation of the effectiveness of different methods of therapy to improve the quality of sleep and in the presence of insomnia during pregnancy was conducted.Systematic search in PubMed, Psycinfo and Medline databases was conducted without limiting the publication date till November 3, 2022. The relevant studies included pregnant women of any age and gestation; they included the clinical intervention schemes aimed at improving sleep quality; the data before and after treatment for one or more sleep-related results were reported. 16 studies were selected with a total of 988 pregnant women. According to the results of researches the effectiveness of different types of interventions was established: cognitive-behavioral therapy for sleep disorders, pharmacotherapy, acupuncture, yoga, relaxation and phytotherapy. The recent publications have determined that sleep disorders have a connection with the adverse pregnancy outcomes, including fetal growth restriction, premature births, weakness of uterine labor activity and high delivery frequency of caesarean section.There is an extremely high relevance and need for high-quality randomized controlled studies about sleep disorders during pregnancy and implementation of effective standard obstetric care programs. There is a necessity to improve psychological care and sleep care during pregnancy to maintain a positive pregnancy course, childbirth and postpartum period. Future clinical studies should be randomized and include a sufficient number of women for statistical efficacy, including checking the effectiveness of cognitive-behavioral insomnia therapy to prevent pregnancy/childbirth complications and somatic diseases in the long-term period.
孕妇睡眠障碍及各种失眠治疗方法的疗效分析(文献综述)
妊娠期睡眠障碍(睡眠障碍)的患病率很高,可能与负面的围产后结局有关。然而,这些情况往往不能得到有效的诊断和治疗。在这篇综述中,系统地评估了不同的治疗方法的有效性,以改善睡眠质量和在怀孕期间失眠的存在。系统检索PubMed、Psycinfo和Medline数据库,不将发表日期限制在2022年11月3日。相关研究包括任何年龄和妊娠期的孕妇;其中包括旨在改善睡眠质量的临床干预方案;报告了治疗前后一项或多项睡眠相关结果的数据。16项研究共纳入988名孕妇。根据研究结果,确立了不同类型干预措施的有效性:认知行为疗法、药物疗法、针灸疗法、瑜伽、放松疗法和植物疗法。最近的研究表明,睡眠障碍与胎儿生长受限、早产、子宫分娩活动弱和剖宫产率高等不良妊娠结局有关。对妊娠期睡眠障碍的高质量随机对照研究和有效的标准产科护理方案的实施具有极高的相关性和必要性。有必要加强孕期的心理护理和睡眠护理,以保持孕期、分娩和产后的良好状态。未来的临床研究应随机化,纳入足够数量的妇女进行统计疗效,包括检查认知行为失眠治疗在长期内预防妊娠/分娩并发症和躯体疾病的有效性。
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