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Patterns and Predictors of Sleep Quality in Taiwanese Pregnant Women

Hung, Hsuan-Man RN, MSN; Tsai, Pei-Shan RN, PhD; Ko, Shu-Hua RN, PhD; Chen, Chung-Hey RN, PhD

MCN, The American Journal of Maternal/Child Nursing: March/April 2013 - Volume 38 - Issue 2 - p 95–101
doi: 10.1097/NMC.0b013e3182659345

Purpose: This study examined the patterns and psychosocial predictors of sleep quality in Taiwanese pregnant women.

Study Design and Methods: A cross-sectional, correlational study design was used. A convenience sample of 400 pregnant women from two urban hospitals in Taiwan participated in this study. Data were collected using six self-report measures: Pittsburgh Sleep Quality Index (PSQI), Edinburgh Prenatal Depression Scale, Perceived Stress Scale, State-Trait Anxiety Inventory, Attitude to Body Image Scale, and Interpersonal Support Evaluation List.

Results: Our findings revealed that the prevalence of pregnancy-associated sleep disturbance (PSQI score >5) was 65.5%. The mean score of the global PSQI was 7.25 ± 3.43, indicating that participant pregnant women in general reported mild sleep disturbance. Trend analyses of PSQI score indicated a linear trend, with a gradual decline in the sleep quality as the pregnancy progressed. Sleep latency, habitual sleep efficiency, and subjective sleep quality scores differed significantly by trimesters. Stepwise multiple regression analyses revealed that the best subsets to predict sleep quality were prenatal depression, prepregnancy sleep quality, current body image, and week of gestation for Taiwanese pregnant women.

Clinical Implications: These findings offer evidence that healthcare professionals should provide sleep counseling to pregnant women, and incorporate depression and body image into a supportive model of sleep-related prenatal care.

Findings of this study revealed the prevalence of pregnancy-associated sleep disturbances.

Hsuan-Man Hung is a Doctoral Student at Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Instructor, Department of Nursing, Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan.

Pei-Shan Tsai is a Professor at Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.

Shu-Hua Ko is an Associate Professor at School of Nursing, Hung Kuang University, Taichung, Taiwan.

Chung-Hey Chen is a Professor at Institute of Allied Health Sciences & Department of Nursing, National Cheng Kung University, Tainan, Taiwan. The author can reached via e-mail at

The authors declare no conflict of interest.

© 2013 Lippincott Williams & Wilkins, Inc.