Sleep Disorder Management During Pregnancy: A Systematic Review and Meta-Analysis Publisher



Nayeri ND ; Moghadam ZB ; Rezaei E
Source: Nursing and Midwifery Studies Published:2025

Abstract

Background: Pregnancy is commonly accompanied by sleep disturbances, which can adversely affect both maternal and fetal health. Although a variety of interventions have been proposed, there is no consensus regarding the most effective approach. Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions designed to improve sleep quality and reduce insomnia during pregnancy. Methods: A comprehensive search of PubMed, MEDLINE, Embase, Web of Science, and CENTRAL databases was performed for studies published between January 2000 and March 2025. Only randomized controlled trials (RCTs) involving pregnant women aged 10-49 years were included. Study selection adhered to PICOS criteria, focusing on interventions targeting sleep quality or insomnia outcomes. Data were pooled using a random-effects model in STATA, and effect sizes were calculated as standardized mean differences (SMD) with 95% confidence intervals (CI), assessing both efficacy and heterogeneity. Results: Eleven RCTs, encompassing a total of 1,176 participants, met the inclusion criteria. Pooled analysis demonstrated that sleep interventions significantly improved sleep quality compared with controls (SMD=-0.81; 95% CI=-1.09 to -0.52; P<0.001). Among the various interventions evaluated -including complementary medicine, water-based exercise, aerobic exercise, cognitive behavioral therapy, and acupuncture- sleep health behavior education showed the most pronounced and sustained improvement, particularly evident at two months post-intervention. Conclusion: Sleep health behavior education appears to be the most effective and durable intervention for enhancing sleep quality during pregnancy. While other approaches, such as acupuncture, cognitive behavioral therapy, and exercise, produced benefits, their long-term effects were inconsistent. These findings support the integration of structured behavioral sleep education into prenatal care as a costeffective, accessible, and sustainable strategy to improve maternal sleep health. Copyright© 2025. This open-access article is published under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License which permits Share (copy and redistribute the material in any medium or format) and Adapt (remix, transform, and build upon the material) under the Attribution-NonCommercial terms. Downloaded from: https://nmsjournal.kaums.ac.ir/