Sleep and sleep disorders during pregnancy and postpartum: The Life-ON study

Objective: to prospectively assess sleep and sleep disorders during pregnancy and postpartum in a large cohort of women.Methods: multicenter prospective Life-ON study, recruiting consecutive pregnant women at a gestational age between 10 and 15 weeks, from the local gynecological departments. The study included home polysomnography performed between the 23rd and 25th week of pregnancy and sleep-related questionnaires at 9 points in time during pregnancy and 6 months postpartum. Results: 439 pregnant women (mean age 33.7 +/- 4.2 yrs) were enrolled. Poor quality of sleep was reported by 34% of women in the first trimester of pregnancy, by 46% of women in the third trimester, and by as many as 71% of women in the first month after delivery. A similar trend was seen for insomnia. Excessive daytime sleepiness peaked in the first trimester (30% of women), and decreased in the third trimester, to 22% of women. Prevalence of restless legs syndrome was 25%, with a peak in the third trimester of pregnancy. Polysomno-graphic data, available for 353 women, revealed that 24% of women slept less than 6 h, and 30.6% of women had a sleep efficiency below 80%. Sleep-disordered breathing (RDI >= 5) had a prevalence of 4.2% and correlated positively with BMI. Conclusions: The Life-ON study provides the largest polysomnographic dataset coupled with longitudinal sub-jective assessments of sleep quality in pregnant women to date. Sleep disorders are highly frequent and distributed differently during pregnancy and postpartum. Routine assessment of sleep disturbances in the peri-natal period is necessary to improve early detection and clinical management.