0360 Sleep Complaints, Regardless of Insomnia Disorder, are Associated with Worse Sleep and Mental Health Outcomes During Late Pregnancy. (27th April 2018) - Lee, J
Abstract: Introduction: Insomnia Disorder (Insomnia) is diagnosed when sleep complaints persist despite adequate sleep opportunity, and are associated with clinically significant distress or impairment. During late pregnancy, sleep complaints are common and multi-factorial. Not all women with sleep complaints meet the diagnostic criteria for Insomnia. This study examined sleep-related impairment and cognitions, and mental health in women during the third trimester of pregnancy. Methods: 159 first-time mothers (age M±SD =33.4 ± 3.4), with singleton pregnancy and without severe physical/psychiatric conditions, completed the following assessments at 28–30 weeks' gestation: Duke Structured Interview for Sleep Disorders, Insomnia Severity Index (ISI), PROMIS Sleep Disturbance, Sleep Related Impairment, Depression, and Anxiety Short Forms, Dysfunctional Beliefs and Attitudes about Sleep Scale, and Glasgow Sleep Effort Scale. These measures were compared amongst women who met criteria for Insomnia (Insomnia Group), and those who did not, further separated into High (ISI>7) and Low (ISI<8) Complaint Groups. Results: 33.3% women scored >7 on the ISI, and 24.5% met DSM-5 criteria for Insomnia (without criterion of 3 months duration). Compared to the Insomnia Group, the High Complaint Group had comparable score on all sleep related measures. The High Complaint Group (and not the Insomnia Group) also reported significantly higher symptoms of depression and anxiety compared to the Low Complaint Group ( p -values<.01, d =.92 and .66 respectively). The Low Complaint Group scored the lowest on all sleep measures ( p ranges <.001 to .02, d ranges 0.52 to 3.04). Conclusion: Sleep complaints, even in absence of Insomnia, are associated with less adaptive sleep-related cognitions and poorer mental health. These findings contradict the notion that during the perinatal transition, sleep complaints are "expected" and do not merit clinical attention unless Insomnia is present. Women with sleep complaints but fall short on Insomnia criteria may be vulnerable for future insomnia and mood disorders. Clinical attention is needed for not only Insomnia, but also complaints of sleep disturbances and related daytime impairment in perinatal women. Support (If Any): Australasian Sleep Association Rob Pierce Grant in Aid, Monash University Strategic Grant Scheme.