Background

Sleep disorders are known to increase in prevalence during pregnancy, and associations between disturbed sleep during pregnancy and adverse outcomes for mother and child have been reported in a number of studies. However, most of these studies were retrospective and too small to satisfactorily demonstrate the association.

Aims

• To prospectively investigate the development of snoring during pregnancy and assess if there is an association between snoring and sleepiness or adverse pregnancy outcomes.
• To study the development of restless legs syndrome during and after pregnancy, and whether it is associated with snoring or other pregnancy-related symptoms.
• To investigate the possible association between depressive symptoms in the postpartum period and sleep related problems during pregnancy, using screening instruments.
• To objectively evaluate sleep disordered breathing in pregnant women compared to non-pregnant controls and to evaluate differences in Epworth Sleepiness Scale scores between the two groups.

Methods

Questionnaires containing subjective rating of snoring, Epworth Sleepiness Scale and symptoms of restless legs were used in all studies. Information from the medical records of the pregnant women was also utilized. For objective evaluation of sleep disordered breathing, nocturnal respiratory recordings were used. In the research for the first three papers the same cohort of 500 pregnant women was followed on three occasions during pregnancy and also after delivery, and for the last paper, 100 other pregnant women were compared to 80 nonpregnant controls.

Results and conclusions

Both snoring and restless legs syndrome increase during pregnancy, but this had no convincing impact on obstetric outcome. Sleep recordings could not verify an increased prevalence of obstructive sleep apnea among pregnant women. Restless legs syndrome was associated with snoring and could persist after delivery. Women who had high scores on the Epworth Sleepiness Scale in the last trimester of pregnancy showed more depressive symptoms in the postpartum period. No difference in item scoring of the Epworth Sleepiness Scale was found between pregnant women and controls.