Prevalence and associated factors of insomnia during pregnancy

Abstract

Introduction: Insomnia during pregnancy is associated with adverse health outcomes but its prevalence in Sri Lankan women is unknown. Objectives: We aimed to determine insomnia prevalence and its associated factors during pregnancy and usage of natural remedies. Methods: A descriptive cross-sectional study was conducted using an online, self-administered questionnaire in Sinhala and English languages, distributed among pregnancy groups on Facebook, namely 'Pregnant Mothers’ and 'Pregnancy Support Sri Lanka. Insomnia was assessed using Insomnia Severity Index. Some factors associated with insomnia were determined using questions adapted from Penn State Worry questionnaire, Stanford Sleep Questionnaire and Pittsburgh Sleep Quality Index. Statistical significance of association between insomnia and selected factors were determined using chi-squared test. Results: Among 404 responders, 8.3%, 46.2% and 45.5% had insomnia in first, second and third trimesters, respectively. The overall prevalence of insomnia was 32.7%, while severe, moderate and subthreshold insomnia were 0.5%, 9.1% and 37.4%, respectively. Insomnia was associated with age >30 years (p=0.017), obesity at booking visit (p=0.019), gestational trimester (p=0.002), low habitual sleep efficiency (p=0.001), irregular sleep routine (p=0.001), back pain (p=0.048), nocturnal dyspnoea (p=0.002), gastritis (p=0.007), GORD symptoms (p=0.001), higher level of worry (p=0.001), foetal-related nocturnal awakenings (p=0.001) and COVID-19 related limitations (p=0.039). None of the women used natural remedies for insomnia but 31.8% practiced listening to classical music, 63.6% religious activities and 14.4% meditation to relieve it. Conclusion: Insomnia during pregnancy was high and associated with several comorbidities. Further research is needed to assess benefits of routine screening for insomnia during pregnancy.