Paradoxical Associations Of Sedentary Behavior With Sleep Quality And Duration In Pregnant Women

Excessive sedentary behavior (SB) and low-quality/inadequate sleep are associated with increased risks of pregnancy complications. Yet, associations of SB with sleep quality/duration in pregnant women have been overlooked. Purpose: To assess associations of total, leisure, occupational, and commuting SB with sleep quality and sleep duration guideline in pregnant women by trimesters and evaluate the role of SB patterns. METHODS: This secondary analysis of a cross-sectional study included 935 pregnant women (age = 30 ± 5.6 years; first trimester = 24.1%, second trimester = 33.9%, third trimester = 42.0). The Sedentary Behavior Questionnaire estimated SB (hours/day) during weekdays and weekends. The Pittsburgh Sleep Quality Index Questionnaire evaluated sleep quality and duration. Adjusted logistic regression models examined the relationships between SB with poor sleep quality and not adhering to sleep duration guideline (7-9 hours/day). RESULTS: The odds of poor sleep quality were significantly higher for each hour increase of SB during weekends only (OR = 1.074 for higher leisure SB in the whole sample; OR = 1.142 for total SB in the pregnant women in their first trimester; p < 0.05 for both) (Table 1.). On the other hand, paradoxical associations were detected between SB and the adherence to sleep duration guideline. While the odds of not adhering to the sleep duration guideline were generally significantly higher for each hour increase in SB during weekdays (ORs ranged from 1.055 to 1.114; p < 0.05 for all), the odds of not adhering to the sleep duration guideline were significantly lower for each hour increase in SB per day or during weekends (ORs ranged from 0.656 to 0.934; p < 0.05 for all). These patterns were more common in pregnant women in their first and third trimesters. CONCLUSION: Observed paradoxical associations suggest that trimesters and SB patterns should be incorporated into efforts to improve sleep quality and duration in pregnant women. 1 Table 1. - Variables Total SB Leisure SB Occupational SB Commuting SB per day per weekday per weekend per day per weekday per weekend per day per weekday per weekend per day per weekday per weekend OR(95% CI) Sleep Quality The whole Sample Poor Sleep Quality 1.031(0.992, 1.071) 1.005(0.957, 1.055) 0.963(0.904, 1.027) 1.020(0.972, 1.070) 0.963(0.904, 1.027) 1.074(1.005, 1.148) 1.092(0.974, 1.222) 1.095(0.992, 1.208) 0.902(0.737, 1.105) 1.040(0.905, 1.196) 1.030(0.881, 1.205) 0.997(0.868, 1.144) First Trimester Poor Sleep Quality 1.091(0.994, 1.196) 0.966(0.856, 1.090) 1.142(1.017, 1.283) 1.060(0.952, 1.188) 0.862(0.725, 1.024) 1.071(0.961, 1.194) 1.220(0.919, 1.622) 1.239(0.974, 1.575) 1.364(0.960, 1.939) 1.184(0.882, 1.590) 0.842(0.556, 1.275) 1.364(0.960, 1.939) Second Trimester Poor Sleep Quality 1.091(0.951, 1.082) 0.999(0.916, 1.091) 1.016(0.933, 1.106) 0.997(0.917, 1.083) 0.947(0.849, 1.056) 1.071(0.961, 1.194) 1.106(0.911, 1343) 1.109(0.929, 1.324) 0.924(0.730, 1.169) 1.020(0.804, 1.293) 1.087(0.830, 1.424) 0.924(0.730, 1.169) Third Trimester Poor Sleep Quality 1.013(0.954, 1.075) 1.028(0.957, 1.104) 0.978(0.901, 1.062) 1.015(0.941, 1.095) 1.016(0.923, 1.118) 0.997(0.897, 1.110) 1.066(0.891, 1.276) 1.065(0.919, 1.234) 0.947(0.687, 1.305) 0.959(0.765, 1.204) 1.002(0.794, 1.266) 0.948(0.765, 1.176) Sleep Duration Guideline The whole Sample Not Adhering to Sleep Duration Guideline 0.986(0.950, 1.023) 1.055(1.007, 1.106) 0.920(0.875, 0.967) 1.014(0.968, 1.062) 1.073(1.010, 1.141) 0.934(0.876, 0.996) 0.930(0.829, 1.044) 0.998(0.905, 1.102) 0.835(0.676, 1.031) 0.895(0.782, 1.024) 1.037(0.891, 1.206) 0.863(0.754, 0.988) First Trimester Not Adhering to Sleep Duration Guideline 0.945(0.867, 1.030) 1.027(0.919, 1.147) 0.912(0.818, 1.016) 1.026(0.925, 1.137) 1.100(0.942, 1.284) 0.922(0.788, 1.079) 0.788(0.587, 1.058) 1.239(0.974, 1.575) 0.757(0.458, 1.250) 0.656(0.485, 0.886) 0.842(0.556, 1.275) 0.876(0.633, 1.214) Second Trimester Not Adhering to Sleep Duration Guideline 0.990(0.931, 1.053) 1.025(0.943, 1.113) 0.962(0.886, 1.045) 0.980(0.906, 1.060) 1.020(0.923, 1.127) 0.961(0.867, 1.065) 0.952(0.785, 1.155) 1.014(0.851, 1.207) 0.861(0.607, 1.222) 1.076(0.858, 1.349) 1.100(0.845, 1.431) 0.900(0.795, 1.234) Third Trimester Not Adhering to Sleep Duration Guideline 1.004(0.947, 1.064) 1.109(1.032, 1.191) 0.868(0.797, 0.945) 1.026(0.954, 1.103) 1.114(1.011, 1.228) 0.891(0.800, 0.994) 1.000(0.838, 1.193) 1.050(0.908, 1.215) 0.832(0.594, 1.165) 0.900(0.723, 1.121) 1.141(0.907, 1.436) 0.754(0.607, 0.938) 2