To Sleep or Not to Sleep, That is the Question: Sleep, Anxiety and Depressive Symptoms in Pregnancy

Miller, Alexis B. (2019) To Sleep or Not to Sleep, That is the Question: Sleep, Anxiety and Depressive Symptoms in Pregnancy. Undergraduate thesis, under the direction of Danielle Maack from Psychology, The University of Mississippi.

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Abstract

Pregnancy is a time associated with many changes in a woman’s body including hormonal, metabolic, physical, and physiological changes (Miller, 2004; Okun, Kiewra, Luther, Wisniewski, & Wisner, 2011). A related concern is pregnant women and the impact of disturbed sleep. According to the Centers for Disease Control and Prevention (CDC), over 36% of the population in Mississippi experience an insufficient amount of sleep (CDC, 2014). Moreover, sleep disturbances in pregnancy are significantly associated with antenatal depressive and anxiety symptoms (Volkovich, Tikotzky, & Manber, 2015; Yu et al., 2017). The present study assessed potential relations between sleep disturbances, anxiety, depressive symptoms and other potential covariates (i.e. maternal age and gravidity) in pregnant Mississippi women. Participants included 438 pregnant women (76.6% Caucasian; Mage = 28.30) recruited at a local OB/GYN clinic in North Mississippi. Sleep disturbances, depressive and anxiety symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), Edinburgh Postnatal Depression Scale (EPDS), and Depression, Anxiety, and Stress Scale – 21 (DASS-21), respectively. Sleep, measured by PSQI, was significantly positively associated with depression symptoms assessed by EPDS (r = .26, p < .01) and anxiety symptoms measured by DASS-21 (r = .33, p < .01). A linear regression demonstrated that antenatal anxiety is a significant predictor of sleep disturbances while controlling for depression, F(2, 296) = 18.44, p < .001. Additionally, correlation analysis demonstrated no significant relationship between disturbed sleep, and age (r = -.03, p = .66) or disturbed sleep, and gravidity (r = .01, p = .81). Anxiety symptoms during pregnancy are a distinct predictor of sleep disturbances in pregnancy. Sleep disturbances, antenatal anxiety and depressive symptoms were all associated with one another. Screening followed by intervention or prevention should be incorporated into routine obstetric appointments in hopes of caring for both the physical and mental well-being of the pregnant woman and her unborn child.

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