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Effectiveness of nonpharmacological sleep interventions in pregnancy: a systematic review and meta-analysis
Pei Chen1, Yueying Wang2, Jinjin Yuan3
1College of Nursing, University of Illinois Chicago, Chicago, Illinois.
Study Objectives:
Sleep problems are common during pregnancy. Maintaining good sleep is critical to maternal and fetal health. The objective of this study was to evaluate the effectiveness of nonpharmacological interventions in improving sleep quality and duration during pregnancy, using objective and self-reported sleep measures.
Methods:
This meta-analysis was conducted ensuring adherence with the preferred reporting items for systematic reviews and meta-analysis guidelines. We systematically searched 5 major electronic databases, PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, and Cochrane. Only randomized-control trials of nonpharmacological interventions to improve sleep in pregnancy were included. We used random or fixed effect models and pooled estimates as standardized mean differences with 95% confidence intervals. Funnel plots and sensitivity analysis were used to assess publication bias and result robustness.
Results:
A total of 31 studies (n = 3,307) were included. Meta-analysis revealed that nonpharmacological interventions significantly improved self-reported overall sleep quality (standardized mean difference = -0.99; 95% confidence interval = -1.40, -0.58; I2 = 96.3%). Subgroup analysis indicated that interventions initiated in late pregnancy (standardized mean difference = -0.88; 95% confidence interval = -1.16, -0.60; I2 = 85.6%) or spanning different pregnancy stages were effective (standardized mean difference = -1.10; 95% confidence interval = -1.97, -0.24; I2 = 98.1%). However, these interventions did not significantly affect sleep duration or efficiency, whether self-reported or objectively measured.
Conclusions:
Nonpharmacological interventions can improve self-reported sleep quality in pregnant females. Clinicians can tailor interventions based on pregnancy period and individual needs to manage their sleep disturbances.
Citation:
Chen P, Wang Y, Yuan J, et al. Effectiveness of nonpharmacological sleep interventions in pregnancy: a systematic review and meta-analysis. J Clin Sleep Med. 2025;21(8):1463-1476.
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