Sleep quality and health among pregnant smokers

Abstract

Study Objectives: We aimed to examine (1) sleep quality trends of pregnant smokers and (2) their associations with health outcomes. Methods: A secondary analysis of 88 participants from the University at Buffalo Pregnancy and Smoking Cessation Study (nonrandomized clinical study) was performed. Sleep quality was measured with the Pittsburgh Sleep Quality Index (higher scores, worse quality) and sleep duration was self-reported repeatedly during pregnancy at preintervention, postintervention, and end-of-pregnancy visits. Participants were divided into 3 groups (until preintervention, until postintervention, until end-of-pregnancy). Maternal outcomes included gestational weight gain and smoking cessation. Infant outcomes included birth weight, gestational age, and Apgar score. Results: There was a significant increase (P = .046) in Pittsburgh Sleep Quality Index score from postintervention (mean, 5.5 [standard deviation (SD), 2.6]) to end of pregnancy (6.6 [SD, 2.8]). Mean gestational weight gain was significantly lower for participants with poor sleep quality than those with good sleep quality (19.0 kg [SD, 21.3] vs 36.1 kg [SD, 22.8]; P = .008). Newborns with poor maternal sleep quality had a significantly lower mean 5-minute Apgar score (8.1 [SD, 1.3] vs 9.0 [SD, 0.0]; P = .021) than newborns with good maternal sleep quality. Preintervention sleep quality was not associated with smoking cessation, birth weight, or gestational age. Smoking cessation was almost half as prevalent in participants with insufficient sleep (< 7 hours/night) vs sufficient sleep duration (47.4% vs 92.3%, P = .011). Conclusions: Sleep quality worsened toward the end of pregnancy among smokers. Poor sleep might negatively influence gestational weight gain and Apgar score. Insufficient preintervention sleep might negatively influence smoking cessation.