Identifying risk factors for probable insomnia development during late pregnancy: Preliminary findings from an Australian cohort study

Pregnancy insomnia symptoms are prevalent and associated with adverse parent and infant outcomes. Psychosocial and cognitive factors may contribute to the development and persistence of insomnia symptoms. To date, there is little evidence exploring these risk factors before the onset of probable insomnia disorder.

To investigate the development of probable insomnia (Insomnia Severity Index: ISI ≥10 with sufficient sleep opportunity) at late pregnancy, we examined a cohort of parents without existing probable insomnia (≤7 ISI) at 26-32 weeks of gestation. We then surveyed this cohort again later in pregnancy (five weeks postbaseline) and conducted multiple logistic regression to calculate the odds of probable insomnia at later pregnancy, based on baseline risk factors. Risk factors included: other children, mental health history, sleep reactivity (Ford Insomnia Response to Stress Test), beliefs about sleep (Dysfunction Beliefs and Attitudes about Sleep Scale), and emotional support (PROMIS Emotional support).

A total of 159 (mean age: 32.9 ±3.7 years) parents were included in the present analysis with 12.4% of these meeting the criteria for probable insomnia at later pregnancy. When considering all risk factors for probable insomnia (other children, mental health history, sleep reactivity, beliefs about sleep, and emotional support), only emotional support showed significantly increased odds of insomnia development (OR: 0.90, p=0.027).

Lower perceived emotional support is associated with increased odds of new onset probable insomnia during late pregnancy. Future research should further explore potential mechanisms underlying these associations, and whether targeting emotional support may lower the risk of insomnia development.