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      Association Between Recent Experience of Childbirth and Sleep Quality in South Korean Women: Results from a Nationwide Study

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          Abstract

          Introduction

          Although women commonly report deterioration of sleep quality postpartum, this relationship has been less studied in East Asian countries. This study investigated the association between recent experience of childbirth and sleep quality in South Korean women and additionally examined how healthy practice behavior interplays in the stated relationship.

          Methods

          Data from the 2018 Community Health Survey were used. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI). Women who responded to have given birth in the past year were categorized as having a recent experience of childbirth. The general characteristics of the study population were investigated using chi-square test. The association between the dependent and independent variables was analyzed using multivariate logistic regression analysis.

          Results

          Of a total of 41,708 study participants, 16,877 (40.5%) individuals reported poor sleep quality. Poor sleep quality was more common in women with a recent experience of childbirth (48.4%) than those without (40.0%). Compared to individuals without a recent experience of childbirth, those with such an experience were more likely to show poor sleep quality (OR 1.50, 95% CI 1.34–1.68). Such differences were reduced in individuals with a healthy lifestyle.

          Conclusion

          Recent experience of childbirth was associated with higher likelihoods of poor sleep quality in women. The degree of risks found was reduced in individuals practicing a healthy lifestyle habit. The findings infer the need to monitor and address sleep-related disturbances commonly reported among postpartum women.

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          Most cited references35

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index.

            The Pittsburgh Sleep Quality Index (PSQI) is a self-reported questionnaire that measures sleep quality during the previous month. The aims of this study were to analyze the reliability and validity of the Korean version of the PSQI (PSQI-K) and to evaluate its usefulness. We developed the PSQI-K, which involved translating the original PSQI into Korean and then translating back into English to check its accuracy. We tested the validity of the PSQI-K on a total of 394 individuals: 261 with poor sleep (primary insomnia, n = 211; narcolepsy, n = 50) and 133 with good sleep. All subjects completed the PSQI-K, 285 had overnight nocturnal polysomnography, and 53 were randomly selected for a retest with the questionnaire after 2-4 weeks without any intervening treatment. The mean PSQI-K global scores in each group were analyzed after adjusting for age and sex. Cronbach's α coefficient for internal consistency of the total score of the PSQI-K was 0.84 which shows high reliability. Sensitivity and specificity for distinguishing poor and good sleepers were 0.943 and 0.844 using the best cutoff point of 8.5. The total and component scores of the PSQI-K for insomnia and narcolepsy were significantly higher than those for controls (p < 0.05). The test-retest correlation coefficient was 0.65 for the total score (p < 0.001). There was no significant difference between the two values using the paired t tests. The PSQI-K is a reliable and valid questionnaire for evaluating sleep quality in patients with sleep disorders.
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              Korea Community Health Survey Data Profiles

              In 2008, Korea Centers for Disease Control and Prevention initiated the first nationwide survey, Korea Community Health Survey (KCHS), to provide data that could be used to plan, implement, monitor, and evaluate community health promotion and disease prevention programs. This community-based cross-sectional survey has been conducted by 253 community health centers, 35 community universities, and 1500 interviewers. The KCHS standardized questionnaire was developed jointly by the Korea Centers for Disease Control and Prevention staff, a working group of health indicators standardization subcommittee, and 16 metropolitan cities and provinces with 253 regional sites. The questionnaire covers a variety of topics related to health behaviors and prevention, which is used to assess the prevalence of personal health practices and behaviors related to the leading causes of disease, including smoking, alcohol use, drinking and driving, high blood pressure control, physical activity, weight control, quality of life (European Quality of Life-5 Dimensions, European Quality of Life-Visual Analogue Scale, Korean Instrumental Activities of Daily Living ), medical service, accident, injury, etc. The KCHS was administered by trained interviewers, and the quality control of the KCHS was improved by the introduction of a computer-assisted personal interview in 2010. The KCHS data allow a direct comparison of the differences of health issues among provinces. Furthermore, the provinces can use these data for their own cost-effective health interventions to improve health promotion and disease prevention. For users and researchers throughout the world, microdata (in the form of SAS files) and analytic guidelines can be downloaded from the KCHS website (http://KCHS.cdc.go.kr/) in Korean.
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                Author and article information

                Journal
                Nat Sci Sleep
                Nat Sci Sleep
                nss
                nss
                Nature and Science of Sleep
                Dove
                1179-1608
                26 March 2021
                2021
                : 13
                : 467-475
                Affiliations
                [1 ]Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center , Goyang-si, Gyeonggi-do, Republic of Korea
                [2 ]Institute of Health Services Research, Yonsei University College of Medicine , Seoul, Republic of Korea
                [3 ]Department of Preventive Medicine and Public Health, Ajou University School of Medicine , Suwon-si, Gyeonggi-do, Republic of Korea
                Author notes
                Correspondence: Soon Young Lee Department of Preventive Medicine and Public Health, Ajou University School of Medicine 206 World Cup-ro , Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of KoreaTel +82-31-219-5301Fax +82-31-219-5084 Email solee@aumc.ac.kr
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0003-4891-0524
                Article
                297964
                10.2147/NSS.S297964
                8009764
                51d0a3bb-b0fe-4d9a-9b6b-d02515110257
                © 2021 Kim et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 17 December 2020
                : 20 February 2021
                Page count
                Figures: 0, Tables: 5, References: 35, Pages: 9
                Funding
                Funded by: financial;
                The present study received no financial support.
                Categories
                Original Research

                sleep quality,sleep disturbances,postpartum,childbirth experience,healthy practice behavior

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