Insomnia in response to stress in pregnant women: description of the problem, complications, identification of risk groups and therapeutic options

Abstract

Insomnia is a major clinical problem in pregnant population, with almost 40% of women in the third trimester being affected. If left untreated, insomnia reduces the quality of life and increases the risk of other disorders, both somatic and mental. Sleep disorders can affect the course of pregnancy, delivery, and perinatal outcomes, as well as prevent the formation of a proper bond between mother and infant, which is crucial for the child’s further development. The term “sleep reactivity,” defining a certain tendency to exhibit sleep disturbance in response to a stressful stimulus, increasingly appears in literature. Sleep reactivity is a part of the body’s overall response to stress. It has been shown that high sleep reactivity can be a risk factor for chronic insomnia, which confirms its clinical significance. Ford Insomnia Response to Stress Test (FIRST) is an available and easy-to-use tool to measure this tendency. Due to the high prevalence and multiple complications of pregnancy insomnia, it is worth using appropriate screening tools to diagnose the disorder during prenatal checkups with the attending physician. In the light of current medical knowledge, cognitive-behavioural therapy of insomnia is the method of choice and should be used in every symptomatic patient. The latest data also indicate its efficacy and safety in advanced pregnancy patients.