www.buffalo.edu

Abstract

ObjectiveWe aimed to examine the trajectories, predictors, and health effects of sleep quality and duration among pregnant smokers.

MethodsWe used data of 58 pregnant smokers enrolled in a smoking cessation intervention study conducted in Buffalo, NY during 2015-2016. Sleep quality and duration were measured with Pittsburgh Sleep Quality Index (PSQI) repeatedly at 3 study visits: pre-test, post-test, and end-of-pregnancy.

ResultsThe sleep quality of pregnant smokers decreased during pregnancy while sleep duration did not changed substantially. At the pre-test, depression and heavy smoking were associated with lower sleep quality. Although not significantly, poor sleep (vs. good sleep) at pre-test seemed to predict a higher risk of failure in smoking cessation (27.8% vs. 16.7%) and insufficient gestational weight gain (25.0% vs. 14.3%).

ConclusionDepression and heavy smoking negatively affect sleep quality among pregnant smokers, which could potentially lead to failure in smoking cessation and insufficient weight gain.

Objective

Methods

Conclusion

Sleep and Health Among Pregnant Smokers Research Assistants: Arsalan Haghdel, Michael Danilov; Principal Investigator: Xiaozhong Wen MD, PhDDivision of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo

• Specific Aim 1: to track sleep quality and duration throughout pregnancy

• Specific Aim 2: to examine the effects of depression, mood disorder, pre-pregnancy weight and smoking frequency on pregnant mothers’ sleep quality and duration

• Specific Aim 3: to examine the impact of pregnant mothers’ sleep quality and duration on gestational weight gain and success in smoking cessation

Results

Acknowledgements• Collaborators: Leonard H. Epstein, Stephen T. Higgins, Rina D. Eiden, Faye E.

Justicia-Linde, Youfa Wang, Kai Ling Kong, Rocco A. Paluch• Research Assistants• Health professionals at recruitment sites• All patients and their families• Sponsors: NIH CTSA Pilot Fund; UB Dept of Pediatrics; CURCA• Contract: Xiaozhong Wen, MD, PhD; Assistant Professor (716-829-6811;

xiaozhon@buffalo.edu), Arsalan Haghdel (arsalanh@buffalo.edu), Michael Danilov(mdanilov@buffalo.edu)

Figure 1. Conceptual Framework

Figure 2. Study Flowchart* *Pittsburgh Sleep Quality Index is administered at each point

Figure 3. Methods of Measurement

Courtesy of www.pinterest.com

Pittsburgh Sleep Quality Index (PSQI)• Subjective Sleep Quality• Sleep Latency• Sleep Duration• Habitual Sleep Efficiency• Sleep Disturbances• Use of Sleep Medication• Daytime Dysfunction PSQI Scoring (0-21) • Poor sleep if score >5

Table 1. Sample Characteristics

Results (cont.)

Figure 5. Impact of Depression on Sleep Quality and Duration

Figure 7. Impact of Sleep Quality on Smoking Cessation Success and Gestational Weight Gain

Figure 6. Impact of Smoking Frequency on Sleep Quality and Duration

• Increase in depression severity and smoking frequency negatively impacts sleep quality among pregnant smokers

• Poor sleep quality could potentially increase the risk of failure in smoking cessation and insufficient gestational weight gain

0

1

2

3

4

5

6

7

8

9

10

�Pre-test Post-test �End of Pregnancy

Slee

p Q

ualit

y Sc

ore

Subjects with pre-test data only

Subjects with pre-test and post-test data only

Subjects with pre-test, post-test and end of pregnancy data

N=6

N=17N=34

Figure 4. Change in Sleep Quality Throughout Pregnancy

Courtesy of www.pregnancyandbaby.comCourtesy of www.thenews.com.pk/

0

1

2

3

4

5

6

7

0

1

2

3

4

5

6

7

8

9

10

NoDepression MildDepression SevereDepression

MeanSleepDu

ra,o

n(Hou

rs)

MeanSleepQua

lityScore

SleepQuality(PSQIScore) SleepDuraDon(hours)

0

1

2

3

4

5

6

7

0

1

2

3

4

5

6

7

8

9

1to4Cigare4es 5to9Cigare4es 10ormoreCigare4es

MeanSleepDu

ra,o

n(Hou

rs)

MeanSleepQua

lityScore

SleepQuality(PSQIScore) SleepDuraCon(hours)

0

5

10

15

20

25

30

FailureinSmokingCessa6on InsufficientGesta6onalWeightGain

Percen

tage

GoodQualitySleep PoorQualitySleep

Characteristic n (%)Age,years ≤24 20 (35.1)25-29 16 (28.1)≥30 21 (36.8)

Race/EthnicityNon-Hispanic Caucasian 14 (24.6)Non-Hispanic Black 34 (59.6)Other 9 (15.8)

High School or Lower Education 29 (50.9)Employed 16 (28.1)Married 16 (28.0)# Cigarettes/Day at Enrollment

1 to 4 11 (19.3)5 to 9 24 (42.1)10 or more 22 (38.6)

Maternal Pre-pregnancy BMIUnderweight or Normal Weight 27 (47.4)Overweight 14 (24.5)Obese 16 (28.1)

Annual Household Income <$5,000 20 (35.1)Mother's Annual Income <$5,000 28 (49.1)Quit Rate After Intervention 74.1%