330 Characteristics Associated with Napping Among Pregnant Women with Insomnia

Abstract

Introduction: Napping is common in pregnant women; however, characteristics associated with napping in pregnant women with insomnia have not been studied. Methods: We used baseline data from a randomized controlled trial of insomnia treatment during pregnancy for this cross‐sectional analysis (n=159). Women self‐reported sociodemographic characteristics (age, race/ethnicity, education, income, employment), pregnancy‐related characteristics (parity, trimester), sleep‐related characteristics (7‐day sleep diary including total napping time per day, Insomnia Severity Index), and depression symptoms (Edinburgh Postnatal Depression Scale). Women were categorized as non‐nappers (0 days with napping), infrequent nappers (1‐3 days with napping), and frequent nappers (≥4 days with napping). Characteristics were compared across napping categories using descriptive statistics and multinomial logistic regression. Results: Eighteen percent of women were frequent nappers, 53% were infrequent nappers, and 30% were non‐nappers. Average time spent napping on days with naps was 67 minutes (SD=35). In unadjusted analyses, frequent nappers were more likely to have a high school diploma or less (36% vs 19%), be unemployed (57% vs 41%), and be nulliparous (21% vs 13%) than non‐nappers. Infrequent nappers were more likely to have a 4‐year college degree (32% vs 11%), have a household income $100k or more (58% vs 45%), be working full time (51% vs 39%), and be nulliparous (26% vs 13%) than non‐nappers. Age, race/ethnicity, trimester, sleep‐related characteristics, and depression symptoms were similar across napping categories. In analyses adjusted for education and trimester, being unemployed (OR=3.6; 95% CI: 0.8, 15.4), working part time (OR=2.3; 95% CI: 0.5, 11.2), and nulliparity (OR=2.4; 95% CI: 0.4, 14.6) were most strongly associated with frequent napping (though confidence intervals were wide) but were not associated with infrequent napping. Sleep‐related characteristics were not associated with frequent or infrequent napping in adjusted analyses. Conclusion: Among pregnant women with insomnia, frequent napping was associated with characteristics that suggest greater feasibility of napping (not working, working part time, pregnant with first child), but was not associated with nocturnal sleep parameters or insomnia severity. Given napping can reduce homeostatic sleep drive at bedtime, it should be addressed during insomnia treatment in pregnant women, particularly among women with greater opportunity to nap.