Assessment and relationship of sleep quality to depression in early pregnancy

Sleep quality is integral to optimal physical functioning and mental health during pregnancy. There has, however, been little work conducted to determine the most appropriate measure of sleep quality in this clinical group, a surprising observation given the complex and dynamic psychobiology of pregnancy. The Pittsburgh Sleep Quality Index (PSQI) was evaluated to determine the usefulness of this measure in early pregnancy. The psychometric properties of the PSQI were evaluated in women at 14 weeks of pregnancy and revealed the instrument to have good internal consistency and convergent and divergent reliability properties. Confirmatory factor analysis suggested that the removal of the PSQI sleeping medications sub‐scale from the global sleep quality total score calculation would improve the utility of this measure in early pregnancy. Women classified as depressed on the basis of Edinburgh Postnatal Depression Scale (EPDS) scores were found to have significantly poorer sleep quality scores on the majority of PSQI sub‐scales. The relationship between sleep quality and depression was found to be statistically significant and clinically relevant during early pregnancy and the PSQI would appear to be an appropriate measure to assess sleep quality in this group.