Sleep Quality and Parasomnia-Related Symptoms Among Pregnant Women in Gujranwala, Pakistan: A Cross-Sectional Study

Abstract Background Sleep disturbances are common in pregnancy and are believed to be related to hormonal, physiological and psychological changes. Parasomnias are a group of poorly recognized sleep disorders. Poor sleep quality in pregnant women has been linked to adverse maternal outcomes such as hypertension and pre-eclampsia, yet data on parasomnia-related symptoms in Pakistani populations are scarce. This study assessed sleep quality among pregnant women in Gujranwala, Pakistan, with particular focus on parasomnia-related symptoms. Methods An analytical, observational cross-sectional study was conducted over six months among pregnant women attending prenatal clinics and maternity hospitals in Gujranwala. Using a non-probability convenience sampling technique, 278 pregnant women were approached, of whom 262 completed a paper-based Pittsburgh Sleep Quality Index (PSQI) questionnaire (94.2% response rate). Data were analyzed in IBM SPSS version 27.0 using descriptive statistics, the Shapiro-Wilk test for normality, frequency and percentage analysis, and Cramér's V to measure the strength of association between individual sleep disturbance items and overall sleep quality. Results The mean global PSQI score was 7.57 ± 4.27 (median, 6.00; range, 0–21). The PSQI scores were not normally distributed (Shapiro-Wilk W = 0.938, p < 0.001) therefore non-parametric analysis was justified. Based on the standard cutoff (PSQI > 5), 165 (63.0%) participants were poor sleepers, and 97 (37.0%) were good sleepers. Cramers V analysis indicated that most of the items on sleep disturbances were significantly related to overall sleep quality. The strongest association was found between difficulty in falling asleep and daytime dysfunction. Night-time bathroom trips, feeling too cold and other miscellaneous causes showed weak, non-significant associations. Conclusions Poor sleep quality was highly prevalent among pregnant women in Gujranwala, affecting nearly two-thirds of participants, a pattern consistent with findings from other regions of Pakistan and internationally. Specific, identifiable disturbances rather than uniform impairment drove most of this burden. These results support the routine screening for sleep problems during pregnancy and the early use of nonpharmacologic interventions, such as education regarding sleep hygiene and behavioral strategies, to protect maternal well-being during pregnancy.