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Yıl:2023; Cilt: 10; Sayı: 2>> Özet
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Türk Uyku Tıbbı Dergisi; 2023;10(2):116-121
Gebelikte Uyku Kalitesinin Trimesterlere Göre Değerlendirilmesi ve İlişkili Faktörlerin İncelenmesi
M Karadeniz, M H Ser, G Benbir Şenel
Zonguldak Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Zonguldak
Amaç: Gebelik süresince uyku süre ve kalitesinde değişiklikler meydana gelmektedir. İnsomni, yetersiz uyku süresi, huzursuz bacaklar sendromu/ Willis-Ekbom hastalığı (HBS/WEH) ile ilişkili semptomlar gebelik süresince gebeler tarafından sık tariflenen uyku problemleridir. Bu çalışmada, gebelik döneminde uyku kalitesindeki bozulmanın trimesterlere göre değerlendirilmesi ve HBS/WEH’in bu bozulmadaki rolü ile klinik ve biyokimyasal belirteçlerle korelasyonunun incelenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya ardışık olarak 100 gebe dahil edilmiş, tüm gebeler rutin prenatal muayene randevuları sırasında klinik özelliklerinin belirlenmesi amacıyla anket yoluyla değerlendirilmiştir. Gebelerin demografik verileri, alışkanlıkları, tıbbi geçmişleri ile Pittsburgh Uyku Kalite İndeksi (PUKİ), Epworth Uykululuk Ölçeği (EUS), HBS/WEH yönünden hastalık süresi, şiddeti, tetikleyici faktörler, aile öyküsü gibi özellikleri kaydedilmiştir. Rutin laboratuvar tetkikleri içinden tam kan sayımı, açlık kan şekeri, böbrek fonksiyon testleri, ferritin, demir ve demir bağlama kapasitesi sonuçları analiz edilmiştir. Bulgular: Çalışmaya dahil edilen gebelerin yaş ortalaması 28,8±6,0 yıldı. Trimesterlere göre bakıldığında, üçüncü trimesterde PUKİ değerleri anlamlı bir şekilde daha yüksekti (p=0,044). EUS değerleri trimesterler arası benzerdi (p=0,524). Gebelerin %34’ünde HBS/WEH saptandı; trimesterler arasında ise fark izlenmedi (p=0,188). HBS/WEH hastalarında PUKİ skoru anlamlı bir şekilde daha yüksekti (p=0,013); ancak PUKİ 5 puan ve üzerinde olması ile anlamlı ilişkili bulunmadı. PUKİ 5 puan ve üzerinde olması ile klinik ve biyokimyasal parametreler arasında anlamlı farklılık görülmedi. Sonuç: Çalışmamızda, gece uyku kalitesinin gebelerde özellikle son trimesterde bozulduğu gösterilmiştir. HBS/WEH varlığında PUKİ değerleri istatistiksel olarak daha yüksektir. Buna karşın, kötü uyku kalitesine sahip olan hastaların sıklığının farklı olmaması ve biyokimyasal parametreler arasında anlamlı bir belirteç saptanmaması, kötü uyku kalitesinin altında yatan diğer faktörlerin de ele alınması gerektiğini göstermektedir.
Evaluation of Sleep Quality in Pregnancy According to Trimesters and Investigation of Related Factors
Objective: Pregnancy causes changes in the duration and quality of sleep. Insomnia, insufficient sleep time, and symptoms associated with restless legs syndrome/Willis-Ekbom disease (RLS/WED) are frequently described during pregnancy. We aimed to evaluate the deterioration in sleep quality during pregnancy according to trimesters and to examine the effect of RLS/WEH and its correlation with clinical and biochemical markers. Materials and Methods: Hundred pregnant women were included in the study prospectively and consecutively. Pregnant women were evaluated to determine their clinical characteristics, including demographic data, habits, and medical backgrounds by using a questionnaire. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), disease duration, severity, triggering factors, and family history for RLS/WEH were recorded. Complete blood count, fasting blood glucose, kidney function tests, ferritin, iron and iron binding capacity were also analyzed. Results: The mean age was 28.8±6.0 years. PSQI values were significantly higher in the third trimester (p=0.044), and ESS values were similar between trimesters (p=0.524). RLS/WEH was detected in 34% of the pregnant women; there was no difference between trimesters (p=0.188). The PSQI score was significantly higher in RLS/WEH patients (p=0.013). There was no significant difference in clinical and biochemical parameters between pregnant women with and without subjective poor sleep quality at night (PSQI >5 points). Conclusion: It is shown that night sleep quality is deteriorated in pregnant women, especially in the last trimester. The fact that the frequency of RLS/ WEH is not different in pregnant women with poor sleep quality suggests the existence of other factors underlying poor sleep quality.

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