Sleep Duration during Pregnancy using an Activity Tracking Device

Abstract

Objective The aim of this study was to describe sleep duration across gestation in women who wore an activity-tracking device (ATD) during pregnancy, and to study the association between sleep duration and adverse maternal and neonatal outcomes

Study Design Women ≥ 18 years old who owned a smartphone were approached to participate in 2016 to 2017. Participants received instructions to wear and sync an ATD daily. Steps, sedentary hours, and sleep duration were wirelessly transmitted via cellular technology. We measured sleep duration for the main episode of sleep and excluded sleep times < 120 minutes. Mixed models were used to assess the trajectory of mean weekly hours of sleep by gestational age. Secondary analyses evaluated differences in pregnancy outcomes between insufficient (< 7/24 hours) and sufficient sleep (≥ 7/24 hours) groups, based on mean hours of sleep within the first 7 days of ATD use.

Results The majority of 94 participants self-reported minority racial–ethnic status (33% non-Hispanic black and 51% Hispanic), had government insurance (83%), were nulliparous (61%), and had pre-pregnancy overweight or obesity (56%). The mean (standard deviation) duration of sleep was 7.2 ± 2.4 hours per 24 hours. In mixed models analyses, gestational age was statistically significantly associated with mean hours of sleep (β = −0.02; 95% confidence interval: −0.04 to −0.01; p < 0.001). Women who had < 7 hours of sleep had greater median daily steps compared with those who had ≥ 7 hours of sleep (median: 7,122; interquartile range [IQR]: 5,167–8,338 vs. median: 5,005; IQR: 4,115–7,059; p < 0.01), but there were no significant differences in other outcomes (sedentary time, gestational weight gain, pregnancy associated hypertension, gestational diabetes, gestational age at delivery, cesarean delivery, or mean birthweight), p  > 0.05 for all comparisons.

Conclusion The mean sleep duration was 7.2 ± 2.4 hours among the 94 women in this cohort and decreased with advancing gestational age. Further research is required to evaluate sleep measurements with ATD in pregnant women and how sleep duration and quality is related to maternal and neonatal outcomes.

Keywords

pregnancy - sleep - activity tracking device

Publication History

Received: 07 January 2020

Accepted: 13 May 2020

Article published online:
23 September 2020

• References

• 1 Cai S, Tan S, Gluckman PD. , et al; GUSTO study group. Sleep quality and nocturnal sleep duration in pregnancy and risk of gestational diabetes mellitus. Sleep (Basel) 2017 40(02):
• 2 Facco FL, Grobman WA, Kramer J, Ho KH, Zee PC. Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism. Am J Obstet Gynecol 2010; 203 (02) 142.e1-142.e5
• 3 Herring SJ, Foster GD, Pien GW. et al. Do pregnant women accurately report sleep time? A comparison between self-reported and objective measures of sleep duration in pregnancy among a sample of urban mothers. Sleep Breath 2013; 17 (04) 1323-1327
• 4 Huberty JL, Buman MP, Leiferman JA, Bushar J, Adams MA. Trajectories of objectively-measured physical activity and sedentary time over the course of pregnancy in women self-identified as inactive. Prev Med Rep 2016; 3: 353-360
• 5 Kominiarek MA, Vyhmeister H, Balmert LC. et al. Activity tracking devices in group prenatal care: a feasibility study. Biores Open Access 2018; 7 (01) 165-176
• 6 Grym K, Niela-Vilén H, Ekholm E. et al. Feasibility of smart wristbands for continuous monitoring during pregnancy and one month after birth. BMC Pregnancy Childbirth 2019; 19 (01) 34
• 7 Xu X, Conomos MP, Manor O, Rohwer JE, Magis AT, Lovejoy JC. Habitual sleep duration and sleep duration variation are independently associated with body mass index. Int J Obes 2018; 42 (04) 794-800
• 8 Watson NF, Badr MS, Belenky G. et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep (Basel) 2015; 38 (06) 843-844
• 9 Tsai SY, Lee PL, Lin JW, Lee CN. Cross-sectional and longitudinal associations between sleep and health-related quality of life in pregnant women: a prospective observational study. Int J Nurs Stud 2016; 56: 45-53
• 10 Reid KJ, Facco FL, Grobman WA. et al. Sleep during pregnancy: the nuMoM2b pregnancy and sleep duration and continuity study. Sleep (Basel) 2017 40(05):
• 11 Facco FL, Kramer J, Ho KH, Zee PC, Grobman WA. Sleep disturbances in pregnancy. Obstet Gynecol 2010; 115 (01) 77-83
• 12 Ayas NT, White DP, Al-Delaimy WK. et al. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care 2003; 26 (02) 380-384
• 13 Beihl DA, Liese AD, Haffner SM. Sleep duration as a risk factor for incident type 2 diabetes in a multiethnic cohort. Ann Epidemiol 2009; 19 (05) 351-357
• 14 Cappuccio FP, Stranges S, Kandala NB. et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study. Hypertension 2007; 50 (04) 693-700
• 15 Gangwisch JE, Heymsfield SB, Boden-Albala B. et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension 2006; 47 (05) 833-839
• 16 Kolla BP, Mansukhani S, Mansukhani MP. Consumer sleep tracking devices: a review of mechanisms, validity and utility. Expert Rev Med Devices 2016; 13 (05) 497-506
• 17 Mantua J, Gravel N, Spencer RM. Reliability of sleep measures from four personal health monitoring devices compared to research-based actigraphy and polysomnography. Sensors (Basel) 2016; 16 (05) E646
• 18 Montgomery-Downs HE, Insana SP, Bond JA. Movement toward a novel activity monitoring device. Sleep Breath 2012; 16 (03) 913-917