Sleep Quality and Its Predictors Among Pregnant Women in Jordan: A Cross-Sectional Study

Zena Alasmer,1,* Mohammad S Nazzal,2,* Zeinab Mohamed,1,* Aisha Al-Jaber,1,* Rana Ali,1,* Feda Alshar,1 Ebaa M Ababneh,2 Eman Alshdaifat,3 Saddam F Kanaan1 1Department of Rehabilitation Science, Qatar University, QU Health, Doha, Qatar; 2Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Obstetrics and Gynecology, Yarmouk University, Irbid, Jordan*These authors contributed equally to this workCorrespondence: Saddam F Kanaan, Ibn Albetar (I-06), Department of Rehabilitation Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar, Tel +97444036077, Email [email protected]: Pregnant women often report poor sleep quality and increased sleep disturbances, especially in the second and third trimesters. Studies showed inconsistent prevalence of poor sleep quality among pregnant women, with unclear predictive factors. Furthermore, physical, psychological, and socioeconomic factors may negatively affect sleep in pregnant women.Purpose: The study aims to explore sleep quality and to identify possible physical, psychological, and socioeconomic predictors of poor sleep quality among pregnant women.Patients and Methods: The cross-sectional study was conducted from July 2021 to January 2022. Pregnant women in their second and third trimesters were recruited during their regular visits to the gynecology and obstetrics clinics and hospitals in northern Jordan. Using convenience sampling, two hundred six participants completed questions about sociodemographics, pregnancy, and women’s health history using the interviewer-administered method. Additionally, participants completed the Pittsburgh Sleep Quality Index (PSQI), Pregnant Physical Activity Questionnaire (PPAQ), and Hospital Anxiety and Depression Scale (HADS). Descriptive statistics were used to analyze sleep quality, and a multivariable linear regression model was used to identify significant predictors of the PSQI total score.Results: 206 pregnant women participated: 23.3% in the second trimester and 73.3% in the third, with a mean age of 30.6 years. 76.6% of pregnant women reported poor sleep quality (PSQI total score > 5). The results showed that increased age (B= 0.125, 95% CI [0.042 - 0.208], p< 0.003), Low educational level (high school or lower vs higher education) (B= 1.097, 95% CI= [0.033– 2.161], p= 0.043), having leg cramps (B= 1.578, 95% CI [0.627– 2.529], p< 0.001), anemia during pregnancy (B= 1.311, 95% CI [0.131– 2.492], p= 0.030), and increased anxiety (B= 0.355, 95% CI [0.258 - 0.452], p< 0.001) are significant predictors poor sleep quality.Conclusion: Poor sleep is highly prevalent among pregnant women due to factors such as age, education, anxiety, and medical conditions. Clinicians should consider this high prevalence and the possible associated factors in assessing and managing sleep quality to improve pregnant women’s health and quality of life.Keywords: women’s health, sleep quality, pregnancy, leg cramps, anxiety, anemia