Natural History of Sleep Disturbance in Childbearing Women: A Feasibility Study

项目摘要/总结 关于妇女从孕前到孕期过渡到孕期的睡眠的前瞻性数据 产后需要预测产妇和婴儿的健康结果。新妈妈的睡眠障碍 这种疾病无处不在，不仅对母亲的健康和福祉， 他们的婴儿。虽然有些睡眠中断可能是正常的，并解决与分娩和适应， 新的母亲，其他人可能是适应不良，并赋予风险，不良怀孕和/或贫穷的孕产妇或 婴儿健康结果。例如，睡眠障碍，全球测量，已与 产前抑郁症、早产、分娩时间延长、剖腹产次数增多以及产后抑郁症。 哪些睡眠障碍特别会带来风险，现在才被描述出来。需要进行纵向研究， 确定什么时候，为谁，在什么条件下，睡眠障碍引起病理。前瞻性 然而，由于在招募具有代表性的大型研究人员方面存在挑战， 样本，维护入组的受试者，并确保及时完成研究工具。一致 本研究的目的是：1）探索一种新的方法的可行性 （通过国家民意调查机构和登记册进行征聘，使用在线问卷系统，提供 通过电子邮件和研究网站定期反馈，以及基于彩票的激励系统），旨在系统地 有效地挑选这种纵向数据; 2）评估孕妇和非孕妇在以下方面的差异： 累积睡眠障碍发病率，并确定哪些具体的睡眠障碍占这些差异;和3） 收集关于睡眠障碍与母婴结局之间关联的试点数据。未生育的妇女， 不打算在未来18个月内怀孕，打算在未来18个月内怀孕，并且目前在 他们的头三个月，将被招募参加一个16-18个月的研究。可行性将通过评估 招聘、保留和遵守率，以及这些是否符合预先规定的门槛标准。两 睡眠连续性和睡眠障碍症状将被系统地跟踪， 结果（例如，疲劳、嗜睡、情绪障碍、妊娠期糖尿病、流产发生率， 早产发生率和出生体重）。鉴于有数据支持这些战略的可行性， 所提出的方法包可以应用于许多纵向设计，包括，并且除了， 建议的研究。最后，拟议研究的内容将有助于估计 睡眠障碍与母婴健康之间的关联（即，一个整体的关联之间的 两组测量）和用于评估特定关联（例如，OSA相关症状和 妊娠糖尿病）。最终，如果成功的话，这项研究计划可能有助于确定睡眠障碍 需要采取干预措施，以促进孕产妇健康和良好的婴儿结果。

PROJECT ABSTRACT/SUMMARY Prospective data on the sleep of women as they transition from pre-pregnancy through pregnancy and to postpartum are needed to predict maternal and infant health outcomes. Sleep disturbance among new mothers is ubiquitous and presents a profound challenge, not only to mothers' health and well-being, but also to that of their infant. While some sleep disruptions may be normative and resolve with childbirth and the adaptation to new motherhood, others may be maladaptive and confer risk for adverse pregnancy and/or poor maternal or infant health outcomes. For example, sleep disturbance, globally measured, has been associated with antenatal depression, preterm birth, longer labors, more C-section deliveries, and postpartum depression. Which sleep disorders specifically confer risk is only now being delineated. Longitudinal studies are needed to determine when, for whom, and under what conditions, sleep disturbance gives rise to pathology. Prospective studies of this nature, however, have been limited, due to challenges in recruiting large, representative samples, maintaining enrolled participants, and ensuring timely completion of study instruments. In keeping with the R21 mechanism, the present study is designed to 1) pilot the feasibility of a novel methodological approach (recruitment via a national polling agency and registry, the use of an online questionnaire system, the provision of regular feedback via email and a study website, and a lottery-based incentive system) aimed to systematically and efficiently cull longitudinal data of this kind; 2) evaluate pregnant and non-pregnant women for differences with respect to cumulative sleep disorder morbidity, and determine which specific sleep disorders account for these differences; and 3) gather pilot data on the association between sleep disturbance and maternal-infant outcomes. Nulliparous women who do not intend to conceive in the next 18 months, who intend to conceive in the next 18 months, and who are currently in their first trimester, will be recruited to participate in a 16-18 month study. Feasibility will be assessed by evaluating recruitment, retention, and compliance rates and whether these meet pre-specified threshold criteria. Both sleep continuity and sleep disorder symptoms will be systematically tracked in relation to maternal and infant outcomes (e.g., fatigue, sleepiness, mood disturbance, gestational diabetes, incidence of pregnancy loss, incidence of pre-term birth, and birth weight). Given data to support the feasibility of these strategies, the methodological package proposed can be applied to numerous longitudinal designs, including, and apart from, the proposed study. Finally, the content of the proposed study will serve to allow an estimation of the overall association between sleep disturbance and maternal and infant health (i.e., an overall association between the two sets of measures) and for the evaluation of specific associations (e.g., OSA-related symptoms and gestational diabetes). Ultimately, if successful, this program of research may help define when sleep disorder interventions are needed to promote both maternal health and good infant outcomes.