Nursing and Midwifery Studies

Nursing and Midwifery Studies

Sleep disorder management during pregnancy: A systematic review and meta-analysis

Document Type : Review

Authors
Nahid Dehghan Nayeri 1
Zahra Behboodi Moghadam 2
Elham Rezaei 3
1 Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
2 Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3 Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
10.48307/nms.2025.504624.1561
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 cost-effective, accessible, and sustainable strategy to improve maternal sleep health.
Keywords
Sleep disorder
Pregnancy
Systematic review

Subjects

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Nursing and Midwifery Studies
Volume 14, Issue 4
Autumn 2025
Pages 330-346

  • Receive Date 04 February 2025
  • Revise Date 07 October 2025
  • Accept Date 26 October 2025