Purpose: This study explored (a) differences in sleep quality, depression, and stress among second- and third-trimester pregnant and nonpregnant women, and (b) relationships among depression, stress, and sleep quality of pregnant women in Taiwan.Design: Cross-sectional.Methods: A convenience sample of 150 second-trimester and 150 third-trimester pregnant women was recruited from two medical centers in Taiwan. A comparison group of 300 nonpregnant women was recruited by the acquaintance technique. Data were collected from October 2006 to September 2007 using a demographic form, Pittsburgh Sleep Quality Index (PSQI), Edinburgh Postnatal Depression Scale, and Perceived Stress Scale.Findings: The prevalence of poor sleepers (PSQI score>5) was 60.0% for second- and third-trimester pregnant women and 48.0% for nonpregnant women. After controlling for significant covariates, pregnant women reported worse global sleep quality, habitual sleep efficiency, and sleep disturbances than nonpregnant women, and poorer sleep quality and sleep latency were most prevalent during their third trimester. A high prevalence of antenatal depression (27.3% to 36.0%) was found in pregnant women, depressed women had worse sleep quality than nondepressed women in all groups, and stress affected sleep quality in pregnant women but not in nonpregnant women.Conclusions: This cross-sectional study provides preliminary evidence that pregnant women suffer significantly more poor sleep quality than nonpregnant women, and that sleep quality of pregnant women was related to stress and depression.Clinical Relevance: Evaluation for sleep quality and depression should be part of routine prenatal check-ups. Information on women's sleep quality, stress, and depressive status can be used to individualize interventions for pregnancy-associated sleep disorder.
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